Provider Demographics
NPI:1114912045
Name:CLAIR, JOY D (CRNA)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:D
Last Name:CLAIR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN537135163W00000X
PA071833367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1543244OtherGATEWAY
PA1668044OtherHIGHMARK
PA50041084OtherCAPITAL ADVANTAGE
PA11802981OtherCAQH
PA2001111OtherKHP CENTRAL
PA1027796370001Medicaid
PA1668044OtherFIRST PRIORITY
PA2343643000OtherINDEP BLUE CROSS
PA9079459OtherAETNA
PA89641OtherGEISINGER
PA1668044OtherHIGHMARK
PA1543244OtherGATEWAY
PA1027796370001Medicaid