Provider Demographics
NPI:1194713297
Name:LINGERFELT, JOYCE R (ARNP MSW RNC)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:R
Last Name:LINGERFELT
Suffix:
Gender:F
Credentials:ARNP MSW RNC
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:R
Other - Last Name:BOSWORTH LINGERFELT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP MSW RNC
Mailing Address - Street 1:1200 E COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:COLVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99114-3354
Mailing Address - Country:US
Mailing Address - Phone:509-684-3701
Mailing Address - Fax:509-684-5817
Practice Address - Street 1:1200 E COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:COLVILLE
Practice Address - State:WA
Practice Address - Zip Code:99114-3354
Practice Address - Country:US
Practice Address - Phone:509-685-7834
Practice Address - Fax:509-684-5817
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000046291041C0700X
WAAP30000029363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9600248Medicaid
WA50517OtherL & I
WA8936538OtherL & I CRIME VICTIMS
WA50517OtherL & I
S26160Medicare UPIN