Provider Demographics
NPI:1568917649
Name:SMITH, JOYCE DENISE (CNA, CCG, ALM)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:DENISE
Last Name:SMITH
Suffix:
Gender:F
Credentials:CNA, CCG, ALM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41402 W HOPPER DR
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-7278
Mailing Address - Country:US
Mailing Address - Phone:520-483-9175
Mailing Address - Fax:520-509-3712
Practice Address - Street 1:41402 W HOPPER DR
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-7278
Practice Address - Country:US
Practice Address - Phone:520-251-4351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-18
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 372600000X, 3747A0650X
AZ251E00000X
AZAZ039603747P1801X
AZCNA1000047205376K00000X
AZALM-011836171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251E00000XAgenciesHome Health
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376K00000XNursing Service Related ProvidersNurse's Aide