Provider Demographics
NPI:1689682668
Name:CICCO, JOYCE C (MSN RN CS)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:C
Last Name:CICCO
Suffix:
Gender:F
Credentials:MSN RN CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E BRADY ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4648
Mailing Address - Country:US
Mailing Address - Phone:724-282-1627
Mailing Address - Fax:724-282-4810
Practice Address - Street 1:901 E BRADY ST
Practice Address - Street 2:SUITE 103
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4648
Practice Address - Country:US
Practice Address - Phone:724-282-1627
Practice Address - Fax:724-282-4810
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN139671L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse