Doctor Name: | LISA KAY YOCUM |
NPI Number: | 1225152200 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PAC |
License Number: | 102312 |
Business Practice Address: | 22545b Hwy 17 North Hampstead, NC - 284433173 |
Business Phone Number: | 9103290300 |
Business Fax Number: | 9103290307 |
Mailing Address: | 22545b Hwy 17 North, HAMPSTEAD |
State: | NC |
Postal Code: | 284433173 |
Phone Number: | 9103290300 |
Fax Number: | 9103290307 |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 03/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 102312 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |