Provider Demographics
NPI:1710784012
Name:JOECKEL, SAYDE DAWN
Entity type:Individual
Prefix:
First Name:SAYDE
Middle Name:DAWN
Last Name:JOECKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-3067
Mailing Address - Country:US
Mailing Address - Phone:913-401-8069
Mailing Address - Fax:
Practice Address - Street 1:4251 NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-1593
Practice Address - Country:US
Practice Address - Phone:816-500-2355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS142407163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse