Provider Demographics
NPI:1447504469
Name:JOYNER, KIMBERLY WEAVER (BSN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:WEAVER
Last Name:JOYNER
Suffix:
Gender:F
Credentials:BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 TAYLORS STORE RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27856-8495
Mailing Address - Country:US
Mailing Address - Phone:252-459-5574
Mailing Address - Fax:
Practice Address - Street 1:3521 TAYLORS STORE RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-8495
Practice Address - Country:US
Practice Address - Phone:252-459-5574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC178804163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant