Provider Demographics
NPI:1487362208
Name:VANOSDOL, YVONNE LYNN
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:LYNN
Last Name:VANOSDOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 CORAL SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:IN
Mailing Address - Zip Code:46034-9214
Mailing Address - Country:US
Mailing Address - Phone:317-775-8143
Mailing Address - Fax:
Practice Address - Street 1:2200 S DIXON RD
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-6406
Practice Address - Country:US
Practice Address - Phone:765-455-4443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28059055A163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation