Provider Demographics
NPI:1871896357
Name:SHEA, JOYCE LAFOLLETTE (CRNP)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:LAFOLLETTE
Last Name:SHEA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WALNUT GROVE DR
Mailing Address - Street 2:
Mailing Address - City:CHURCH HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37642-6095
Mailing Address - Country:US
Mailing Address - Phone:256-710-6726
Mailing Address - Fax:
Practice Address - Street 1:U.S. DIABETES CARE OF MORRISTOWN, LLC/
Practice Address - Street 2:2231 SANDSTONE DR
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814
Practice Address - Country:US
Practice Address - Phone:423-616-0635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-06
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNANP0000032931163WD0400X, 363LA2100X
TN240519326163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-13198OtherBCBS OF ALABAMA
AL126683Medicaid