Provider Demographics
NPI:1679592554
Name:CREED, JOY K (FNP-C)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:K
Last Name:CREED
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14558 DANVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:LAUREL FORK
Mailing Address - State:VA
Mailing Address - Zip Code:24352-3982
Mailing Address - Country:US
Mailing Address - Phone:276-398-1200
Mailing Address - Fax:276-398-2094
Practice Address - Street 1:109 CARROLL DRIVE
Practice Address - Street 2:
Practice Address - City:FRIES
Practice Address - State:VA
Practice Address - Zip Code:24330-4532
Practice Address - Country:US
Practice Address - Phone:888-908-4788
Practice Address - Fax:276-398-2094
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165309363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
C05711OtherMEDICARE GROUP #
VA010149207Medicaid
P76618Medicare UPIN
006930T11Medicare PIN