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General NPI Number Information
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NPI Number | 1124116975
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Entity Type | Individual
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Provider Name | MRS. YVETTE BOOKER
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4100 W 3RD ST
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City | DAYTON
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State | OH
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Zip | 45428-9000
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Country | US
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Telephone | 937-268-6511
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Fax |
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Provider Business Mailing Address
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Address Line | 319 SANDALWOOD DR
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City | DAYTON
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State | OH
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Zip | 45405-2924
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Country | US
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Telephone | 937-718-6251
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN.073565-MEDS
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License Number State | OH
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