Provider Demographics
NPI:1477067098
Name:MINOR, JOY ELISHA (MA)
Entity Type:Individual
Prefix:MS
First Name:JOY
Middle Name:ELISHA
Last Name:MINOR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3789 WILLOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-3500
Mailing Address - Country:US
Mailing Address - Phone:317-830-9134
Mailing Address - Fax:
Practice Address - Street 1:3789 WILLOWOOD DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-3500
Practice Address - Country:US
Practice Address - Phone:317-830-9134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INHHA1504454374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide