Provider Demographics
NPI:1366153165
Name:KATIE JOY PLLC
Entity type:Organization
Organization Name:KATIE JOY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:PACKER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:602-320-4818
Mailing Address - Street 1:14478 W WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2035
Mailing Address - Country:US
Mailing Address - Phone:602-320-4818
Mailing Address - Fax:623-257-7610
Practice Address - Street 1:14478 W WINDSOR AVE
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2035
Practice Address - Country:US
Practice Address - Phone:602-320-4818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty