Doctor Name: | JOY C RAYBOURN |
NPI Number: | 1609097278 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN,BC |
License Number: | 060927 |
Business Practice Address: | 4696 South Farm Road 53 Republic, MO - 657382361 |
Business Phone Number: | 4172695016 |
Business Fax Number: | 4172696849 |
Mailing Address: | 4696 South Farm Road 53, REPUBLIC |
State: | MO |
Postal Code: | 65738 |
Phone Number: | 4172695016 |
Fax Number: | 4172696849 |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 060927 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |