MEDICARE: JAIME YATES

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN2371639	MA

General Provider Information

NPI Number	:	1215327382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIME YATES

Provider Business Mailing Address
First Line	:	383 JUNE ST
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02720-3544
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	383 JUNE ST
Second Line	:
City	:	FALL RIVER
State	:	MA
Zip	:	02720-3544
Country	:	US
Telephone Number	:	508-837-3951
Fax Number	:	508-738-4054

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

Provider Enumeration Date	:	01/28/2015
Last Update Date	:	04/20/2026

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