Provider Demographics
NPI:1952938714
Name:MICCIO, JOY H (RN)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:H
Last Name:MICCIO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:2525 S DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5817
Mailing Address - Country:US
Mailing Address - Phone:303-765-6891
Mailing Address - Fax:303-778-5291
Practice Address - Street 1:2525 S DOWNING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5817
Practice Address - Country:US
Practice Address - Phone:303-765-6891
Practice Address - Fax:303-778-5291
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COAPN.0995739-NP363LF0000X
CO0995739363LF0000X
CORXN.0104924-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000192181Medicaid