Provider Demographics
NPI:1649495888
Name:JOYNER, CHRISTIAN HAUSLER (PA)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:HAUSLER
Last Name:JOYNER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5215 COLLEY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-2172
Mailing Address - Country:US
Mailing Address - Phone:757-402-3707
Mailing Address - Fax:757-266-5727
Practice Address - Street 1:5215 COLLEY AVE STE A
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-2172
Practice Address - Country:US
Practice Address - Phone:757-402-3707
Practice Address - Fax:757-266-5727
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002437363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA354728OtherBLUE CROSS/BLUE SHIELD
VA5618622Medicaid
VA354728OtherBLUE CROSS/BLUE SHIELD