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General NPI Number Information
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NPI Number | 1730407552
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Entity Type | Individual
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Provider Name | MATTHEW MICHAEL YODER FNP
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Gender | Male
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Dates
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Enumeration Date | 05/05/2010
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 2225 N AUGUSTA ST STE B
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City | STAUNTON
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State | VA
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Zip | 24401-2520
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Country | US
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Telephone | 403-249-0485
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Fax | 833-464-4861
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Provider Business Mailing Address
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Address Line | PO BOX 229
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City | VERONA
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State | VA
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Zip | 24482-0229
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Country | US
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Telephone | 540-324-9048
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024168892
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License Number State | VA
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