MEDICARE: JOANNA ELIZABETH KREYLING CPNP-PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	20091475	IN

General Provider Information

NPI Number	:	1477851400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA ELIZABETH KREYLING CPNP-PC

Provider Business Mailing Address
First Line	:	8151 AUTUMN DR
Second Line	:
City	:	GEORGETOWN
State	:	IN
Zip	:	47122-8905
Country	:	US
Telephone Number	:	812-399-1067
Fax Number	:

Provider Business Practice Location Address
First Line	:	223 W SPRING ST
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-3612
Country	:	US
Telephone Number	:	812-949-1616
Fax Number	:	812-945-8365

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2011
Last Update Date	:	02/28/2011

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