Healthcare Provider Details

I. General information

NPI: 1891125266
Provider Name (Legal Business Name): GREGORY YEYE NURSE PRACTITIONER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2013
Last Update Date: 11/18/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4075 N DUBLIN GRANVILLE RD
DUBLIN OH
43017-1486
US

IV. Provider business mailing address

333 N SUMMIT ST FL 15 NATASHIA DUPREE
TOLEDO OH
43604
US

V. Phone/Fax

Practice location:
  • Phone: 800-427-9012
  • Fax: 800-564-5952
Mailing address:
  • Phone:
  • Fax: 800-564-5952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number397254
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.0028238
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN.CNP.0028238
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: