Provider Demographics
NPI:1194956110
Name:MOLES, JOY M (CRNA)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:M
Last Name:MOLES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:M
Other - Last Name:FAULKNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2201 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-2843
Mailing Address - Country:US
Mailing Address - Phone:606-408-6806
Mailing Address - Fax:606-408-6807
Practice Address - Street 1:804 SCOTT NIXON MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-2464
Practice Address - Country:US
Practice Address - Phone:800-394-4445
Practice Address - Fax:706-650-1034
Is Sole Proprietor?:No
Enumeration Date:2009-08-07
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1119675367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered