Provider Demographics
NPI:1669829594
Name:PRICE, JOY ALLEN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:ALLEN
Last Name:PRICE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 COUNTY ROAD 436
Mailing Address - Street 2:
Mailing Address - City:RIENZI
Mailing Address - State:MS
Mailing Address - Zip Code:38865-9776
Mailing Address - Country:US
Mailing Address - Phone:662-462-7711
Mailing Address - Fax:
Practice Address - Street 1:15 COUNTY ROAD 436
Practice Address - Street 2:
Practice Address - City:RIENZI
Practice Address - State:MS
Practice Address - Zip Code:38865-9776
Practice Address - Country:US
Practice Address - Phone:662-462-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18195363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily