Provider Demographics
NPI:1699986596
Name:ANSCHULTZ, JOYCE DEANN (APN)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:DEANN
Last Name:ANSCHULTZ
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9302 LAUREL HILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6027 WALNUT GROVE RD STE 402
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2129
Practice Address - Country:US
Practice Address - Phone:901-767-0101
Practice Address - Fax:901-767-0304
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000012686363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1511466Medicaid
MS04086291Medicaid