Provider Demographics
NPI:1942649975
Name:SICKLES, JOY KRISTINE (CNP)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:KRISTINE
Last Name:SICKLES
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:
Other - Last Name:STANSBERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:936 BARCARMIL WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-0903
Mailing Address - Country:US
Mailing Address - Phone:239-265-3391
Mailing Address - Fax:239-566-9915
Practice Address - Street 1:936 BARCARMIL WAY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-0903
Practice Address - Country:US
Practice Address - Phone:239-265-3391
Practice Address - Fax:239-566-9915
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.14559363LF0000X
FLAPRN11012824363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0087553Medicaid
OHH224312Medicare PIN
OHH224313Medicare PIN
H224310Medicare PIN
OH0087553Medicaid
OHH224317Medicare PIN
OHH224318Medicare PIN
OHH224315Medicare PIN
OHH224314Medicare PIN