Provider Demographics
NPI:1073519757
Name:MONSMA, JOY (APRN)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:MONSMA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 950244
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0244
Mailing Address - Country:US
Mailing Address - Phone:502-953-4700
Mailing Address - Fax:502-776-8912
Practice Address - Street 1:2215 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40212-1033
Practice Address - Country:US
Practice Address - Phone:812-218-8926
Practice Address - Fax:812-218-8930
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3001819363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78009727Medicaid
KY000000174062OtherANTHEM
KY0538408Medicare PIN
KY000000174062OtherANTHEM
KY78009727Medicaid
KYP400033776Medicare PIN
KY0538508Medicare PIN
KY0538608Medicare PIN