Provider Demographics
NPI:1679282560
Name:DAY, JOEL NETHANIEL (CRNA)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:NETHANIEL
Last Name:DAY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2244 WINKLER AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9155
Mailing Address - Country:US
Mailing Address - Phone:304-654-3044
Mailing Address - Fax:
Practice Address - Street 1:4670B HUGHES BRANCH RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-9776
Practice Address - Country:US
Practice Address - Phone:304-654-3044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV95540163W00000X
WV119263367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
143188OtherCRNA CERTIFICATE
WV95540OtherRN