Healthcare Provider Details

I. General information

NPI: 1982503546
Provider Name (Legal Business Name): KATY YEOMANS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2026
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 DURRENCE RD
JESUP GA
31545-7827
US

IV. Provider business mailing address

475 DURRENCE RD
JESUP GA
31545-7827
US

V. Phone/Fax

Practice location:
  • Phone: 912-427-1061
  • Fax: 912-427-1069
Mailing address:
  • Phone: 912-427-1061
  • Fax: 912-427-1069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN716738
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: