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General NPI Number Information
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NPI Number | 1417073214
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Entity Type | Individual
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Provider Name | STACEY A. YEAMANS LPN
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 261 CONNECTICUT DR STE 5
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City | BURLINGTON
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State | NJ
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Zip | 08016-4177
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Country | US
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Telephone | 609-387-7322
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Fax |
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Provider Business Mailing Address
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Address Line | 9 MOORE RD W
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City | TABERNACLE
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State | NJ
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Zip | 08088-8842
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Country | US
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Telephone | 609-268-2188
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 26NP03194200
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License Number State | NJ
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