Provider Demographics
NPI:1194260760
Name:MOYER-DIENER, JOANNA (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:MOYER-DIENER
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-2416
Mailing Address - Country:US
Mailing Address - Phone:956-648-1614
Mailing Address - Fax:
Practice Address - Street 1:801 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-2416
Practice Address - Country:US
Practice Address - Phone:956-648-1614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001249285163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant