Provider Demographics
NPI:1710238472
Name:JOYNER, ANTHONY LOPEZ (LPN)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:LOPEZ
Last Name:JOYNER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 N 15TH ST
Mailing Address - Street 2:
Mailing Address - City:WYANDANCH
Mailing Address - State:NY
Mailing Address - Zip Code:11798-2312
Mailing Address - Country:US
Mailing Address - Phone:910-574-4181
Mailing Address - Fax:347-945-0938
Practice Address - Street 1:36 N 15TH ST
Practice Address - Street 2:
Practice Address - City:WYANDANCH
Practice Address - State:NY
Practice Address - Zip Code:11798-2312
Practice Address - Country:US
Practice Address - Phone:910-574-4181
Practice Address - Fax:347-945-0938
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311479164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse