Provider Demographics
NPI:1518363340
Name:VASTOLA, JONI LYNN (FNP-C)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:LYNN
Last Name:VASTOLA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JONI
Other - Middle Name:LYNN
Other - Last Name:CUTSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2020 EXETER RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3945
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:660 S MOUNT JULIET RD STE 220
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3920
Practice Address - Country:US
Practice Address - Phone:615-885-1093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19349363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ010075Medicaid
TNQ010075Medicaid