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NPI Code Detail

MEDICARE: KIM A YEAKEL PNP

MEDICARE: KIM A YEAKEL PNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse PractitionerAP2112AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134374754
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM A YEAKEL PNP
Provider Business Mailing Address
First Line : 3200 E CAMELBACK RD
Second Line : STE 250
City : PHOENIX
State : AZ
Zip : 85018-2327
Country : US
Telephone Number : 602-933-1814
Fax Number : 602-933-1820
Provider Business Practice Location Address
First Line : 2120 N CENTRAL AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1455
Country : US
Telephone Number : 602-933-6100
Fax Number : 602-933-2422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2008
Last Update Date : 06/17/2021

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