Healthcare Provider Details

I. General information

NPI: 1427241629
Provider Name (Legal Business Name): LINDA B. YAVERBAUM PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 04/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL DR
HENDERSONVILLE NC
28792-5272
US

IV. Provider business mailing address

107 FAIRVIEW OAKS LN
ASHEVILLE NC
28803-8811
US

V. Phone/Fax

Practice location:
  • Phone: 828-681-2146
  • Fax:
Mailing address:
  • Phone: 540-383-8128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110002572
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: