Provider Demographics
NPI:1700676343
Name:YODER, JOAN KAY
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:KAY
Last Name:YODER
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 1:20 ROAD 6185
Mailing Address - Street 2:
Mailing Address - City:KIRTLAND
Mailing Address - State:NM
Mailing Address - Zip Code:87417-9323
Mailing Address - Country:US
Mailing Address - Phone:505-716-8070
Mailing Address - Fax:
Practice Address - Street 1:20 ROAD 6185
Practice Address - Street 2:
Practice Address - City:KIRTLAND
Practice Address - State:NM
Practice Address - Zip Code:87417-9323
Practice Address - Country:US
Practice Address - Phone:505-716-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator