Doctor Name: | MRS. KIMBERLY ANN YEAGER |
NPI Number: | 1669812681 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN,BC,FNP |
License Number: | 2007019920 |
Business Practice Address: | 330 N State St Suite C Desloge, MO - 636013052 |
Business Phone Number: | 5734314449 |
Business Fax Number: | 5734312443 |
Mailing Address: | 330 N State St, Suite C DESLOGE |
State: | MO |
Postal Code: | 636013052 |
Phone Number: | 5734314449 |
Fax Number: | 5734312443 |
NPI Enumeration Date: | 07/05/2013 |
NPI Last Update Date: | 07/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SF0001X |
License Number: | 2007019920 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Family Health |
Taxonomy Definition: |