Provider Demographics
NPI:1932328408
Name:DREW-ELLIS, JOYCE RENEE
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:RENEE
Last Name:DREW-ELLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13500 WILLOWCREST LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-2705
Mailing Address - Country:US
Mailing Address - Phone:804-739-4834
Mailing Address - Fax:
Practice Address - Street 1:13500 WILLOWCREST LN
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-2705
Practice Address - Country:US
Practice Address - Phone:804-739-4834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002059400164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse