Provider Demographics
NPI:1255463832
Name:LOPEZ, JOY LYNN (RN)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:LYNN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:LYNN
Other - Last Name:GADBERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2027 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-2621
Mailing Address - Country:US
Mailing Address - Phone:440-812-2800
Mailing Address - Fax:
Practice Address - Street 1:2027 W 10TH ST
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-2621
Practice Address - Country:US
Practice Address - Phone:440-812-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-256767163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2165240OtherINDEPENDENT PROVIDER #