Healthcare Provider Details

I. General information

NPI: 1730480724
Provider Name (Legal Business Name): JOY E MCLAIN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2010
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 BRISTOL WEST BLVD STE 2C
BRISTOL TN
37620-8773
US

IV. Provider business mailing address

PO BOX 9
KINGSPORT TN
37662-0009
US

V. Phone/Fax

Practice location:
  • Phone: 423-844-1399
  • Fax:
Mailing address:
  • Phone: 423-857-2066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-50864
License Number StateZZ
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number18724
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: