Provider Demographics
NPI:1548081425
Name:MITCHELL-JOYCE, JESSIKA JAYNE (CPHT, BCPA)
Entity type:Individual
Prefix:
First Name:JESSIKA
Middle Name:JAYNE
Last Name:MITCHELL-JOYCE
Suffix:
Gender:F
Credentials:CPHT, BCPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1763 W KNEELAND RD
Mailing Address - Street 2:
Mailing Address - City:MIO
Mailing Address - State:MI
Mailing Address - Zip Code:48647-9739
Mailing Address - Country:US
Mailing Address - Phone:989-390-0805
Mailing Address - Fax:
Practice Address - Street 1:1763 W KNEELAND RD
Practice Address - Street 2:
Practice Address - City:MIO
Practice Address - State:MI
Practice Address - Zip Code:48647-9739
Practice Address - Country:US
Practice Address - Phone:989-390-0805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303004271183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty