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General NPI Number Information
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NPI Number | 1083265516
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Entity Type | Individual
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Provider Name | YVA JEAN-MARC NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/25/2019
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 22707 S ELLSWORTH RD STE H101
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-7568
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Country | US
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Telephone | 480-792-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 2487 S GILBERT RD STE 106-132
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City | GILBERT
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State | AZ
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Zip | 85295-2804
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Country | US
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Telephone | 813-965-3044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 07190632
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License Number State | AZ
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