MEDICARE: SUSAN YARBOROUGH

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
1	363LF0000X	Family Nurse Practitioner	36207	TN

General Provider Information

NPI Number	:	1558898163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN YARBOROUGH

Provider Business Mailing Address
First Line	:	170 MOUSE CREEK RD NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-3840
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	170 MOUSE CREEK RD NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-3840
Country	:	US
Telephone Number	:	423-458-1426
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2017
Last Update Date	:	12/18/2025

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Directions to “ SUSAN YARBOROUGH ” Practice Location

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