Basic Information
Provider Information
NPI: 1164771804
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: IGBER
FirstName: JOY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2728 CASTLE ST
Address2:  
City: NORTH LAS VEGAS
State: NV
PostalCode: 890303830
CountryCode: US
TelephoneNumber: 7022170627
FaxNumber:  
Practice Location
Address1: 600 B ST STE 1570
Address2:  
City: SAN DIEGO
State: CA
PostalCode: 921014560
CountryCode: US
TelephoneNumber: 6196150439
FaxNumber: 6196153197
Other Information
ProviderEnumerationDate: 09/07/2012
LastUpdateDate: 04/21/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X818979CAY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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