Healthcare Provider Details

I. General information

NPI: 1770439671
Provider Name (Legal Business Name): ANTONIO JOYNER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44121 LEESBURG PIKE STE 275
ASHBURN VA
20147-5671
US

IV. Provider business mailing address

44121 LEESBURG PIKE STE 275
ASHBURN VA
20147-5671
US

V. Phone/Fax

Practice location:
  • Phone: 757-392-6780
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024196713
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: