Provider Demographics
NPI:1114584885
Name:IYORIOBHE, JOY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:IYORIOBHE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15503 SEMINOLE CANYON DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7350
Mailing Address - Country:US
Mailing Address - Phone:919-244-4354
Mailing Address - Fax:
Practice Address - Street 1:15503 SEMINOLE CANYON DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7350
Practice Address - Country:US
Practice Address - Phone:919-244-4354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-28
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX941294163WM0705X
TXAP142543363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical