Provider Demographics
NPI:1093083784
Name:JOHN, YVONNE V (RN)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:V
Last Name:JOHN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1383 DEAN ST
Mailing Address - Street 2:APT 3E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3450
Mailing Address - Country:US
Mailing Address - Phone:347-750-7170
Mailing Address - Fax:800-742-2541
Practice Address - Street 1:1383 DEAN ST
Practice Address - Street 2:APT 3E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3450
Practice Address - Country:US
Practice Address - Phone:347-750-7170
Practice Address - Fax:800-742-2541
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY430151-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse