Healthcare Provider Details

I. General information

NPI: 1699172437
Provider Name (Legal Business Name): NAOMI I YAGER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2014
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 WASHINGTON ST
WINCHESTER MA
01890-1328
US

IV. Provider business mailing address

800 WALNUT ST FL 10
PHILADELPHIA PA
19107-5176
US

V. Phone/Fax

Practice location:
  • Phone: 781-756-5000
  • Fax:
Mailing address:
  • Phone: 215-829-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN2291697
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN2291697
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: