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Individual
MRS. JOYCE VISSAGE
Active
Individual
MRS. JOYCE VISSAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
P2224
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1060
—
SC
05
—
RHC195
—
SC
Enumeration date
02/07/2006
Last updated
06/21/2012
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