Provider Demographics
NPI:1881679850
Name:OLDHAM, JOYE BETH (FNP MSN APRN BC)
Entity Type:Individual
Prefix:
First Name:JOYE
Middle Name:BETH
Last Name:OLDHAM
Suffix:
Gender:F
Credentials:FNP MSN APRN BC
Other - Prefix:
Other - First Name:JOYE
Other - Middle Name:BETH
Other - Last Name:DYCUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN BC
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:DIXON SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37057-0085
Mailing Address - Country:US
Mailing Address - Phone:615-374-3500
Mailing Address - Fax:615-374-2244
Practice Address - Street 1:5 HIGHERS DRIVE
Practice Address - Street 2:OLDHAM FAMILY CLINIC
Practice Address - City:DIXON SPRINGS
Practice Address - State:TN
Practice Address - Zip Code:37057-1215
Practice Address - Country:US
Practice Address - Phone:615-374-3500
Practice Address - Fax:615-374-2244
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006655363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P88424Medicare UPIN
TN3907096Medicare PIN