Provider Demographics
NPI:1952667966
Name:JOINER, AUDREY C (ARNP)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:C
Last Name:JOINER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3685 OAK LN
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-7519
Mailing Address - Country:US
Mailing Address - Phone:321-720-5882
Mailing Address - Fax:
Practice Address - Street 1:1460 BAYTREE DR NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-3900
Practice Address - Country:US
Practice Address - Phone:321-914-0915
Practice Address - Fax:321-914-0916
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1178172363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health