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General NPI Number Information
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NPI Number | 1356389514
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Entity Type | Individual
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Provider Name | CRYSTAL YEAGER PA
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Gender | Female
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 56 MARIE LANGDON DR
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City | MANCHESTER
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State | KY
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Zip | 40962-6329
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Country | US
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Telephone | 606-599-4080
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Fax | 606-598-1688
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Provider Business Mailing Address
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Address Line | 509 MEMORIAL DR STE 2
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City | MANCHESTER
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State | KY
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Zip | 40962-6196
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Country | US
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Telephone | 606-598-8813
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Fax | 606-598-1688
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA792
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License Number State | KY
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