MEDICARE: YORDANKA RAKEVA RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	759172	GA

General Provider Information

NPI Number	:	1205254034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YORDANKA RAKEVA RN

Provider Business Mailing Address
First Line	:	153 S PALM DR
Second Line	:	APT. 6
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-3532
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	153 S PALM DR
Second Line	:	APT. 6
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-3532
Country	:	US
Telephone Number	:	404-729-4468
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2014
Last Update Date	:	03/29/2014

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