Most Relevant Information
Provider Data
| NPI Number: | 1003246257 |
| Provider Name: | JOYCE WALLACE CRNA, ARNP |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 9309567 |
Most Important Dates
| Enumeration Date: | 11/24/2013 |
| Last Updated: | 01/20/2014 |
Provider Practice Location
2165 HERSCHEL ST
JACKSONVILLE
FL
322043819
Practice Location Phone/Fax
| Phone: | 9043874030 |
| Fax: |
Provider Mailing Location
916 ALAMEDA LN
SAINT JOHNS
FL
322596903
Provider Mailing Phone/Fax
| Phone: | 4195123374 |
| Fax: |