Provider Demographics
NPI:1396482741
Name:ELSTON, JOANA (AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JOANA
Middle Name:
Last Name:ELSTON
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:JOANA
Other - Middle Name:
Other - Last Name:REYNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13276 IVANPAH RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-6043
Mailing Address - Country:US
Mailing Address - Phone:760-953-0890
Mailing Address - Fax:
Practice Address - Street 1:380 E PASEO EL MIRADOR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4842
Practice Address - Country:US
Practice Address - Phone:760-323-6531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020971363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care