Provider Demographics
NPI:1376764563
Name:GASKA, JOY M (NP)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:M
Last Name:GASKA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 LEWISVILLE CLEMMONS RD
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8905
Mailing Address - Country:US
Mailing Address - Phone:336-713-0400
Mailing Address - Fax:
Practice Address - Street 1:108 S STATE ST
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-8249
Practice Address - Country:US
Practice Address - Phone:336-679-2733
Practice Address - Fax:336-679-6263
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209-006544363LF0000X
NC5006947363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCJ558AMedicare PIN
ILK38626Medicare PIN
ILK38625Medicare PIN