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General NPI Number Information
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NPI Number | 1477863744
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Entity Type | Individual
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Provider Name | YANINA V, SHAMES PNP
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Gender | Female
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 4901 E 5TH ST CODAC
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City | TUCSON
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State | AZ
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Zip | 85711-2203
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Country | US
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Telephone | 520-318-9222
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Fax | 520-318-9049
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Provider Business Mailing Address
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Address Line | 4901 E 5TH ST CODAC
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City | TUCSON
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State | AZ
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Zip | 85711-2203
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Country | US
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Telephone | 520-318-9222
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Fax | 520-318-9049
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP3829
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License Number State | AZ
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