Individual
REBECCA SUE JOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 E HARRIS AVE, SAN ANGELO, TX 76903-5904
(325) 658-1511
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP122628
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8126NM
BCBS
TX
Enumeration date
06/10/2013
Last updated
12/17/2014
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