Provider Demographics
NPI:1447617774
Name:STYLES, JOAN
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:STYLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 LIVONIA AVE APT 11D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-6059
Mailing Address - Country:US
Mailing Address - Phone:646-240-5960
Mailing Address - Fax:
Practice Address - Street 1:315 LIVONIA AVE APT 11D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-6059
Practice Address - Country:US
Practice Address - Phone:545-240-5960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-17
Last Update Date:2016-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY710079163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse