Provider Demographics
NPI:1497792782
Name:JOYCE, EILEEN T (CRNA)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:T
Last Name:JOYCE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16860 S HIGHLAND RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:VILLAGE OF LOCH LLOYD
Mailing Address - State:MO
Mailing Address - Zip Code:64012-4177
Mailing Address - Country:US
Mailing Address - Phone:816-309-3179
Mailing Address - Fax:
Practice Address - Street 1:3651 COLLEGE BLVD
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1904
Practice Address - Country:US
Practice Address - Phone:816-389-6030
Practice Address - Fax:816-389-6034
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS54726367500000X
MO2000161286367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSJ88A935Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER