Provider Demographics
NPI:1417087172
Name:PADGETT, JOAN M (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:M
Last Name:PADGETT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:M
Other - Last Name:JEMISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:WILBERFORCE
Mailing Address - State:OH
Mailing Address - Zip Code:45384-0208
Mailing Address - Country:US
Mailing Address - Phone:937-376-3086
Mailing Address - Fax:
Practice Address - Street 1:4100 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45428-9000
Practice Address - Country:US
Practice Address - Phone:937-262-2109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN129986163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult