Provider Demographics
NPI:1215435201
Name:JOY, KRISTEN A (DPT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:A
Last Name:JOY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 MEBANE OAKS RD
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-7951
Mailing Address - Country:US
Mailing Address - Phone:919-563-1825
Mailing Address - Fax:919-563-1833
Practice Address - Street 1:1704 W INNES ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2552
Practice Address - Country:US
Practice Address - Phone:704-633-4606
Practice Address - Fax:704-633-5991
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP17637225100000X
NC17637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1215435201Medicaid