Provider Demographics
NPI:1235907874
Name:STILLWAUGH, JOANN RHEA (RN BSN)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:RHEA
Last Name:STILLWAUGH
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 CLEMANS DR
Mailing Address - Street 2:
Mailing Address - City:NACHES
Mailing Address - State:WA
Mailing Address - Zip Code:98937-9730
Mailing Address - Country:US
Mailing Address - Phone:509-930-1825
Mailing Address - Fax:
Practice Address - Street 1:338 CLEMANS DR
Practice Address - Street 2:
Practice Address - City:NACHES
Practice Address - State:WA
Practice Address - Zip Code:98937-9730
Practice Address - Country:US
Practice Address - Phone:509-930-1825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00157960163WH0200X, 163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WH0200XNursing Service ProvidersRegistered NurseHome Health