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General NPI Number Information
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NPI Number | 1265518567
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Entity Type | Individual
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Provider Name | NURA F YASIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/29/2006
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 1111 GARREDD BLVD STE A
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City | AUGUSTA
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State | GA
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Zip | 30909-6751
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Country | US
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Telephone | 706-863-5776
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Fax | 706-868-7057
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Provider Business Mailing Address
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Address Line | 1604 ORCHARD DR
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City | CANTON
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State | MI
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Zip | 48188-1547
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Country | US
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Telephone | 913-279-0600
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301092485
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L2114580
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0431966
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 84792
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License Number State | GA
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