Joy Renee Autry, RN, CLC

Individual provider Active NPI Lactation Consultant (Registered Nurse) · Lexington, SC

NPI 1043071145 · NPPES record last updated Jan 17, 2024

Key facts

NPI
1043071145
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Registered Nurse) 163WL0100X
License
255588 (SC)
Practice address
113 E Main St
Lexington, SC 29072-3449
Phone
(803) 704-4759
NPI assigned
Jan 17, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
255588SCMDLactation Consultant (Registered Nurse)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 255588 SC Yes

Addresses

Primary practice location

113 E Main St
Lexington, SC 29072-3449

Mailing address

138 Caddis Creek Rd
Irmo, SC 29063-8138
Phone (803) 351-1107

Other practice location 1

1033 Kinley Rd
Irmo, SC 29063-9635
Phone (803) 376-2838 ext. 0656

Other providers in Lexington, SC

All providers in Lexington, SC · Lactation Consultant (Registered Nurse) in South Carolina

Sources for this page

Verify at the official NPI Registry.