Provider Demographics
NPI:1700605730
Name:BADAR, JOEY ANN MAE (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:JOEY ANN MAE
Middle Name:
Last Name:BADAR
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10676 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-4903
Mailing Address - Country:US
Mailing Address - Phone:820-667-7372
Mailing Address - Fax:
Practice Address - Street 1:10676 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4903
Practice Address - Country:US
Practice Address - Phone:820-667-7372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95032493363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner