Healthcare Provider Details

I. General information

NPI: 1982169660
Provider Name (Legal Business Name): BRIDGET YEATTS MSN,RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2019
Last Update Date: 02/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24077 STATE HIGHWAY 49
NEVADA CITY CA
95959-8519
US

IV. Provider business mailing address

24077 STATE HIGHWAY 49
NEVADA CITY CA
95959-8519
US

V. Phone/Fax

Practice location:
  • Phone: 530-265-9057
  • Fax:
Mailing address:
  • Phone: 530-265-9057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95176755
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: