Healthcare Provider Details

I. General information

NPI: 1538944830
Provider Name (Legal Business Name): KELLEY RENEE' YARBROUGH-YALE DNP, APRN, ACCNS-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 08/28/2023
Certification Date: 08/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S MAIN ST
FORT WORTH TX
76104-4917
US

IV. Provider business mailing address

7825 ARNOLD TER
NORTH RICHLAND HILLS TX
76180-7307
US

V. Phone/Fax

Practice location:
  • Phone: 817-702-8144
  • Fax:
Mailing address:
  • Phone: 817-368-5565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberAP135676
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: