MEDICARE: YANCI J SHROYER PMHNP

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	209.024027	IL
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1427723345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YANCI J SHROYER PMHNP

Provider Business Mailing Address
First Line	:	1707 E MAIN ST STE 8
Second Line	:
City	:	OLNEY
State	:	IL
Zip	:	62450-3156
Country	:	US
Telephone Number	:	618-839-3198
Fax Number	:

Provider Business Practice Location Address
First Line	:	1707 E MAIN ST STE 8
Second Line	:
City	:	OLNEY
State	:	IL
Zip	:	62450-3156
Country	:	US
Telephone Number	:	618-839-3198
Fax Number	:

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

Provider Enumeration Date	:	08/12/2021
Last Update Date	:	12/30/2025

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