Healthcare Provider Details

I. General information

NPI: 1427723345
Provider Name (Legal Business Name): YANCI J SHROYER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 E MAIN ST STE 8
OLNEY IL
62450-3156
US

IV. Provider business mailing address

1707 E MAIN ST STE 8
OLNEY IL
62450-3156
US

V. Phone/Fax

Practice location:
  • Phone: 618-839-3198
  • Fax:
Mailing address:
  • Phone: 618-839-3198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209.024027
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: