Provider Demographics
NPI:1427519867
Name:CRAVEN, JOYCE A (LPN)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:A
Last Name:CRAVEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 HUGHES
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-8433
Mailing Address - Country:US
Mailing Address - Phone:517-213-9364
Mailing Address - Fax:
Practice Address - Street 1:508 HUGHES
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-8433
Practice Address - Country:US
Practice Address - Phone:517-213-9364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703051916164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse