Provider Demographics
NPI:1609965631
Name:JACQUET, JOYCE GARCIA (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:GARCIA
Last Name:JACQUET
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 1:3435 NAPA BLVD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-4507
Mailing Address - Country:US
Mailing Address - Phone:440-937-0346
Mailing Address - Fax:440-937-0373
Practice Address - Street 1:3435 NAPA BLVD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-4507
Practice Address - Country:US
Practice Address - Phone:440-937-0346
Practice Address - Fax:440-937-0373
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH49333367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered