Healthcare Provider Details

I. General information

NPI: 1245645977
Provider Name (Legal Business Name): YANNA LI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2014
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N HANOVER ST
CARLISLE PA
17013-2421
US

IV. Provider business mailing address

807 MARSHALL DR
CARLISLE PA
17013-1665
US

V. Phone/Fax

Practice location:
  • Phone: 717-218-6670
  • Fax: 717-218-6671
Mailing address:
  • Phone: 917-605-1137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP013749
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN603297
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: