Provider Demographics
NPI:1447736079
Name:RECOR, JOANN ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:ELIZABETH
Last Name:RECOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33764 31ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-7721
Mailing Address - Country:US
Mailing Address - Phone:253-838-0631
Mailing Address - Fax:
Practice Address - Street 1:33764 31ST AVE SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-7721
Practice Address - Country:US
Practice Address - Phone:253-838-0631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00049121163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse