MEDICARE: NICHOLE YOST CNP,FNP-BC

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	363LF0000X	Family Nurse Practitioner	CP001507	SD

General Provider Information

NPI Number	:	1285043752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLE YOST CNP,FNP-BC

Provider Business Mailing Address
First Line	:	5622 SHERIDAN LAKE RD STE 105
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-8881
Country	:	US
Telephone Number	:	605-354-1734
Fax Number	:	605-791-1849

Provider Business Practice Location Address
First Line	:	5622 SHERIDAN LAKE RD STE 105
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-8881
Country	:	US
Telephone Number	:	605-787-2170
Fax Number	:	605-791-1849

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

Provider Enumeration Date	:	08/08/2014
Last Update Date	:	10/06/2020

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