Doctor Name: | MISS DORCAS ANN YATES |
NPI Number: | 1003889254 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN CFNP |
License Number: | R15456 |
Business Practice Address: | 1010 E Roosevelt Ave Grants, NM - 870202118 |
Business Phone Number: | 5052872948 |
Business Fax Number: | 5052875372 |
Mailing Address: | 1010 E Roosevelt Ave, GRANTS |
State: | NM |
Postal Code: | 870202118 |
Phone Number: | 5052872948 |
Fax Number: | 5052875372 |
NPI Enumeration Date: | 02/08/2006 |
NPI Last Update Date: | 12/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R15456 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |