Healthcare Provider Details

I. General information

NPI: 1467833459
Provider Name (Legal Business Name): EDWARD YEICH CRNP, FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 N DUKE ST
LANCASTER PA
17602-2020
US

IV. Provider business mailing address

740 N DUKE ST APT 5J
LANCASTER PA
17602-2061
US

V. Phone/Fax

Practice location:
  • Phone: 717-625-0024
  • Fax:
Mailing address:
  • Phone: 717-925-0024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95002513
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP016031
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: