Provider Demographics
NPI:1194438010
Name:JOINER, KYLIE RAE (FNP)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:RAE
Last Name:JOINER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KYLIE
Other - Middle Name:
Other - Last Name:SHARMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6005 WATSON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:GA
Mailing Address - Zip Code:31008-6542
Mailing Address - Country:US
Mailing Address - Phone:478-956-5002
Mailing Address - Fax:
Practice Address - Street 1:6005 WATSON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:GA
Practice Address - Zip Code:31008-6542
Practice Address - Country:US
Practice Address - Phone:478-956-5002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN268410363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily