Basic Information
Provider Information
NPI: 1275903585
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HENRY
FirstName: JOY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1923 SULPHUR SPRINGS RD
Address2:  
City: MORRISTOWN
State: TN
PostalCode: 378135654
CountryCode: US
TelephoneNumber: 4233719344
FaxNumber: 4237142355
Practice Location
Address1: 815 W 5TH NORTH ST
Address2:  
City: MORRISTOWN
State: TN
PostalCode: 378143810
CountryCode: US
TelephoneNumber: 4235865032
FaxNumber: 4235818473
Other Information
ProviderEnumerationDate: 09/29/2015
LastUpdateDate: 09/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/29/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X20496TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home