Healthcare Provider Details

I. General information

NPI: 1679136394
Provider Name (Legal Business Name): SUZANNE YAWS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 MEDI PARK DR STE 2058
AMARILLO TX
79106-2109
US

IV. Provider business mailing address

1901 MEDI PARK DR STE 2058
AMARILLO TX
79106-2109
US

V. Phone/Fax

Practice location:
  • Phone: 806-354-9540
  • Fax: 806-354-9588
Mailing address:
  • Phone: 806-354-9540
  • Fax: 806-354-9588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11012512
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number226254
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP141407
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number227790
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: