Healthcare Provider Details

I. General information

NPI: 1912726100
Provider Name (Legal Business Name): ZOEIE YETTON RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 10/07/2024
Certification Date: 10/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 SARATOGA DR
EVANSVILLE IN
47715-1974
US

IV. Provider business mailing address

2520 SARATOGA DR
EVANSVILLE IN
47715-1974
US

V. Phone/Fax

Practice location:
  • Phone: 812-276-6956
  • Fax:
Mailing address:
  • Phone: 812-276-6956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number30010679A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: