Provider Demographics
NPI:1518973064
Name:ALLEN, JOYCE ANN (APRN-FNP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:ALLEN
Suffix:
Gender:F
Credentials:APRN-FNP
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:ANN
Other - Last Name:SHEPHERD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ALLEN
Mailing Address - Street 1:444 LEWIS DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-7723
Mailing Address - Country:US
Mailing Address - Phone:859-583-9275
Mailing Address - Fax:
Practice Address - Street 1:1306 VERSAILLES RD
Practice Address - Street 2:STE 120
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-1796
Practice Address - Country:US
Practice Address - Phone:859-259-2635
Practice Address - Fax:859-254-7974
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003869363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78008612Medicaid
KY3003869OtherAPRN LICENSE NUMBER
KY3869POtherARNP
KYK096840Medicare PIN
KY78008612Medicaid