Provider Demographics
NPI:1982919023
Name:COURVILLE, JONI LATIOLAIS (PD)
Entity Type:Individual
Prefix:MRS
First Name:JONI
Middle Name:LATIOLAIS
Last Name:COURVILLE
Suffix:
Gender:F
Credentials:PD
Other - Prefix:MISS
Other - First Name:JONI
Other - Middle Name:MICHELLE
Other - Last Name:LATIOLAIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PD
Mailing Address - Street 1:1102 PARKVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-2883
Mailing Address - Country:US
Mailing Address - Phone:337-560-1807
Mailing Address - Fax:337-560-4219
Practice Address - Street 1:1102 PARKVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2883
Practice Address - Country:US
Practice Address - Phone:337-560-1807
Practice Address - Fax:337-560-4219
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.015867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist