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General NPI Number Information
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NPI Number | 1144817792
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Entity Type | Organization
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Legal Business Name | TERRY JEAN YONKER PSYCHIATRIC NURSE PRACTITIONER PC
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Dates
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Enumeration Date | 12/30/2020
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Last Update Date | 12/30/2020
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Provider Practice Location Address
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Address Line | 3458 LYON RD
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City | MARION
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State | NY
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Zip | 14505-9443
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Country | US
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Telephone | 315-310-7148
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Fax | 315-310-7148
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Provider Business Mailing Address
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Address Line | 3458 LYON RD
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City | MARION
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State | NY
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Zip | 14505-9443
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Country | US
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Telephone | 315-310-7148
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. TERRY JEAN YONKER
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Credential | PMHNP-BC
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Telephone | 315-310-7148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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