Healthcare Provider Details

I. General information

NPI: 1841164258
Provider Name (Legal Business Name): ERIN DARBY YEATES AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N GRAND AVE STE 310
PUEBLO CO
81003-2729
US

IV. Provider business mailing address

207 KENWOOD DR
PUEBLO CO
81004-1621
US

V. Phone/Fax

Practice location:
  • Phone: 719-595-7680
  • Fax:
Mailing address:
  • Phone: 925-640-9422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.1002072-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: