Healthcare Provider Details

I. General information

NPI: 1780638783
Provider Name (Legal Business Name): STEVEN KENT YEAGER ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13670 WALSINGHAM RD
LARGO FL
33774-3532
US

IV. Provider business mailing address

13670 WALSINGHAM RD
LARGO FL
33774-3532
US

V. Phone/Fax

Practice location:
  • Phone: 727-593-9848
  • Fax: 727-596-4532
Mailing address:
  • Phone: 727-593-9848
  • Fax: 727-596-4532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1709132
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: