Provider Demographics
NPI:1649785759
Name:GOBEN, JOY (APRN)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:GOBEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 180
Mailing Address - Street 2:
Mailing Address - City:SEBREE
Mailing Address - State:KY
Mailing Address - Zip Code:42455-0180
Mailing Address - Country:US
Mailing Address - Phone:270-318-5088
Mailing Address - Fax:270-318-3131
Practice Address - Street 1:7139 STATE ROUTE 56 E
Practice Address - Street 2:
Practice Address - City:SEBREE
Practice Address - State:KY
Practice Address - Zip Code:42455-2136
Practice Address - Country:US
Practice Address - Phone:270-318-5088
Practice Address - Fax:270-318-3131
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011920363L00000X, 363LF0000X
IN71007985A363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner