Provider Demographics
NPI:1316198534
Name:JOY, YVONNE L (APRN)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:L
Last Name:JOY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:YVONNE
Other - Middle Name:L
Other - Last Name:LATAILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 KNOLL RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-2145
Mailing Address - Country:US
Mailing Address - Phone:860-347-3065
Mailing Address - Fax:
Practice Address - Street 1:25 KNOLL RIDGE CT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-2145
Practice Address - Country:US
Practice Address - Phone:860-539-5262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily