MEDICARE: MS. EMMA LOIS YODER CNM

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	367A00000X	Advanced Practice Midwife	64035	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	161357	OTHER	KS	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1861470098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMMA LOIS YODER CNM

Provider Business Mailing Address
First Line	:	5506 S RIVERTON RD
Second Line	:
City	:	PARTRIDGE
State	:	KS
Zip	:	67566-9489
Country	:	US
Telephone Number	:	620-567-2627
Fax Number	:	620-465-2712

Provider Business Practice Location Address
First Line	:	2913 E. RED ROCK RD
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67501
Country	:	US
Telephone Number	:	620-465-2712
Fax Number	:	620-465-2712

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/08/2007

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