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General NPI Number Information
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NPI Number | 1306820329
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Entity Type | Individual
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Provider Name | YOLANDA S TYNES ARNP
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Gender | Female
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 416 CENTRAL AVENUE GRAVES COUNTY HEALTH DEPARTMENT
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City | MAYFIELD
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State | KY
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Zip | 42066
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Country | US
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Telephone | 270-247-3553
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Fax | 270-247-0392
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Provider Business Mailing Address
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Address Line | 907 OAK LEVEL RD
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City | BENTON
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State | KY
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Zip | 42025-5391
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Country | US
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Telephone | 270-703-0390
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 2145P
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License Number State | KY
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