Healthcare Provider Details

I. General information

NPI: 1184066789
Provider Name (Legal Business Name): YVONNE K VICOLA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YVONNE K KENDALL

II. Dates (important events)

Enumeration Date: 07/24/2013
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

997 N MAIN ST
WASHINGTON PA
15301-2807
US

IV. Provider business mailing address

1024 HILTY RD
SALTSBURG PA
15681-4202
US

V. Phone/Fax

Practice location:
  • Phone: 412-502-5188
  • Fax:
Mailing address:
  • Phone: 724-331-0512
  • Fax: 412-279-3416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP012994
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: