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: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 FIRST COLONIAL RD STE 403
VIRGINIA BEACH VA
23454-2406
US

IV. Provider business mailing address

1080 FIRST COLONIAL RD STE 403
VIRGINIA BEACH VA
23454-2406
US

V. Phone/Fax

Practice location:
  • Phone: 757-395-1850
  • Fax: 855-707-7855
Mailing address:
  • Phone: 757-395-1850
  • Fax: 855-707-7855

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: