Provider Demographics
NPI:1366442626
Name:GILL, JOYCE D (CRNA)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:D
Last Name:GILL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12752 KINGSTON PIKE
Mailing Address - Street 2:SUITE E202
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-0948
Mailing Address - Country:US
Mailing Address - Phone:865-777-0909
Mailing Address - Fax:865-777-0910
Practice Address - Street 1:723 BURKESVILLE HWY
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:KY
Practice Address - Zip Code:42602-1654
Practice Address - Country:US
Practice Address - Phone:606-387-6421
Practice Address - Fax:865-777-0910
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN041581367500000X
KY3006057367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3625068Medicaid
KY74000399Medicaid
TN3057326OtherBCBS NUMBER
TN3625068Medicare ID - Type Unspecified