Provider Demographics
NPI:1558989194
Name:TINNES, JOY C
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:C
Last Name:TINNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:C
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:3056 RIVER CROSSING CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:IA
Mailing Address - Zip Code:52327-4733
Mailing Address - Country:US
Mailing Address - Phone:319-467-8383
Mailing Address - Fax:
Practice Address - Street 1:3056 RIVER CROSSING CT
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:IA
Practice Address - Zip Code:52327-4733
Practice Address - Country:US
Practice Address - Phone:319-467-8383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17818183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist