=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275566705
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GERALDINE FRANCES YARNE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2006
-----------------------------------------------------
Last Update Date | 11/08/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 127 S 5TH AVE
-----------------------------------------------------
City | TUCSON
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85701-2005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-202-1758
-----------------------------------------------------
Fax | 520-202-1703
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1650 E FORT LOWELL RD SUITE 202
-----------------------------------------------------
City | TUCSON
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85719-2374
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-327-4505
-----------------------------------------------------
Fax | 520-202-1889
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 26084
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------