Healthcare Provider Details

I. General information

NPI: 1487871844
Provider Name (Legal Business Name): RITA ETHEL YEADA R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 S SYCAMORE ST
LITTLETON CO
80120-8201
US

IV. Provider business mailing address

1785 S EMERSON ST
DENVER CO
80210-3229
US

V. Phone/Fax

Practice location:
  • Phone: 303-723-4285
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number55227
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: