Provider Demographics
NPI:1629585575
Name:STVIL, JOANN YAMILE (RN)
Entity Type:Individual
Prefix:MISS
First Name:JOANN
Middle Name:YAMILE
Last Name:STVIL
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 1:1892 PRESERVE CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-8795
Mailing Address - Country:US
Mailing Address - Phone:470-360-5558
Mailing Address - Fax:
Practice Address - Street 1:1892 PRESERVE CREEK WAY
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-8795
Practice Address - Country:US
Practice Address - Phone:470-360-5558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-01
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN288464163WH0200X
NY743580163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty