Healthcare Provider Details

I. General information

NPI: 1033296298
Provider Name (Legal Business Name): JANE KATHRYN YULE APRN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/28/2020
Certification Date: 06/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 BREN RD E
MINNETONKA MN
55343-9664
US

IV. Provider business mailing address

53928 893 RD
BLOOMFIELD NE
68718-4090
US

V. Phone/Fax

Practice location:
  • Phone: 402-309-0599
  • Fax:
Mailing address:
  • Phone: 402-373-4893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number110563
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: