Provider Demographics
NPI:1457327918
Name:JOYNER, DEBRA K (PA C)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:K
Last Name:JOYNER
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: MANAGED CARE DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:394 SINGLETON RIDGE RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-9150
Practice Address - Country:US
Practice Address - Phone:843-347-8765
Practice Address - Fax:843-347-3499
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPA 412363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC107547Medicaid
SC80023036OtherSELECT HEALTH
NC8101825Medicaid
SC958856OtherWELLCARE
SC0698PAMedicaid
SC9549340OtherAETNA
SC107547Medicaid
SC958856OtherWELLCARE
SC0698PAMedicaid