Individual
JOYA HEART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
483 S LOOP RD, EDGEWOOD, KY 41017-5446
(859) 301-4600
Mailing address
483 S LOOP RD, EDGEWOOD, KY 41017-5446
(859) 301-4600
(859) 301-4600
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G79791
CA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
FT591
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G797910
—
CA
Enumeration date
11/15/2006
Last updated
11/20/2018
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