Doctor Name: | MELANIE ANN YURKOVICH |
NPI Number: | 1962772335 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | F.N.P. |
License Number: | 484876 |
Business Practice Address: | 1919 Vista Del Lago Valley Springs, CA - 952529294 |
Business Phone Number: | 2097729538 |
Business Fax Number: | 2097720312 |
Mailing Address: | 768 Mountain Ranch Rd, SAN ANDREAS |
State: | CA |
Postal Code: | 952499707 |
Phone Number: | 2097543521 |
Fax Number: | |
NPI Enumeration Date: | 01/03/2012 |
NPI Last Update Date: | 03/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 484876 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |