Provider Demographics
NPI:1679604003
Name:LUNDEEN, JOY NELSON (RN BCN BCIA-EEG)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:NELSON
Last Name:LUNDEEN
Suffix:
Gender:F
Credentials:RN BCN BCIA-EEG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4548
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83001-4548
Mailing Address - Country:US
Mailing Address - Phone:307-739-7532
Mailing Address - Fax:307-739-7613
Practice Address - Street 1:555 EAST BROADWAY AVENUE
Practice Address - Street 2:SUITE 210
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001-0358
Practice Address - Country:US
Practice Address - Phone:307-739-7532
Practice Address - Fax:307-739-7613
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY11276163WN0800X, 163W00000X, 163WA0400X, 163WG0000X, 163WC1600X, 163WP0000X, 163WP0808X, 163WP0809X, 163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent