Provider Demographics
NPI:1932234572
Name:WEINER, JOY COBERN (APRN)
Entity Type:Individual
Prefix:MS
First Name:JOY
Middle Name:COBERN
Last Name:WEINER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:JOY
Other - Middle Name:L
Other - Last Name:COBERN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:4071 TATES CREEK CENTRE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-3062
Mailing Address - Country:US
Mailing Address - Phone:859-260-4385
Mailing Address - Fax:859-260-4386
Practice Address - Street 1:2350 GREY LAG WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2477
Practice Address - Country:US
Practice Address - Phone:859-263-3873
Practice Address - Fax:859-263-3823
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2923P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0000000205733OtherANTHEM BLUE CARD
KY0627003Medicare PIN
KY0000000205733OtherANTHEM BLUE CARD