Provider Demographics
NPI:1417447467
Name:CREASON, JOY LEE
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:LEE
Last Name:CREASON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US ARMY DENATL ACTIVITY 6958 NEBRASKA AVE BLDG 1608
Mailing Address - Street 2:US ARMY DENATL ACTIVITY 6958 NEBRASKA AVE BLDG 1608
Mailing Address - City:DPO
Mailing Address - State:AA
Mailing Address - Zip Code:65473
Mailing Address - Country:US
Mailing Address - Phone:573-596-0364
Mailing Address - Fax:
Practice Address - Street 1:6958 NEBRASKA AVE BLDG 1608
Practice Address - Street 2:
Practice Address - City:FORT LEONARD WOOD
Practice Address - State:MO
Practice Address - Zip Code:65473-1618
Practice Address - Country:US
Practice Address - Phone:573-596-0364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist