Provider Demographics
NPI:1083829667
Name:(MARTIN) MCGAHA, JOY YVONNE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:YVONNE
Last Name:(MARTIN) MCGAHA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6226 MURRAY AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-7639
Mailing Address - Country:US
Mailing Address - Phone:440-998-6628
Mailing Address - Fax:
Practice Address - Street 1:731 BRANDT RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:OH
Practice Address - Zip Code:44041-9350
Practice Address - Country:US
Practice Address - Phone:440-415-0824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH105392164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse