Provider Demographics
NPI:1518224658
Name:AHN, JOY (BSN, RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:AHN
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 N DELAWARE AVE STE 300D
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-4335
Mailing Address - Country:US
Mailing Address - Phone:267-788-0909
Mailing Address - Fax:
Practice Address - Street 1:1080 N DELAWARE AVE STE 300D
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-4335
Practice Address - Country:US
Practice Address - Phone:267-788-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN560788163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse