Provider Demographics
NPI:1477851400
Name:KREYLING, JOANNA ELIZABETH (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:ELIZABETH
Last Name:KREYLING
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8151 AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47122-8905
Mailing Address - Country:US
Mailing Address - Phone:812-399-1067
Mailing Address - Fax:
Practice Address - Street 1:223 W SPRING ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-3612
Practice Address - Country:US
Practice Address - Phone:812-949-1616
Practice Address - Fax:812-945-8365
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20091475363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics