Provider Demographics
NPI:1184108854
Name:WANSE, JOY (FNP)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:WANSE
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4645 SWEETWATER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3016
Mailing Address - Country:US
Mailing Address - Phone:713-777-5334
Mailing Address - Fax:281-565-1102
Practice Address - Street 1:4645 SWEETWATER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3016
Practice Address - Country:US
Practice Address - Phone:713-777-5334
Practice Address - Fax:281-565-1102
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX822355163W00000X
TX1014959363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse