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NPI Code Detail

MEDICARE: YARVARIOUS TARVETT LANE PMHNP

MEDICARE: YARVARIOUS TARVETT LANE 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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN-NP196763GA
2163W00000XRegistered NurseRN196763GA

General Provider Information

NPI Number : 1477077360
Entity Type Code : Individual
Provider Name (Legal Business Name) : YARVARIOUS TARVETT LANE PMHNP
Provider Business Mailing Address
First Line : 1200 BROOKSTONE CENTRE PKWY STE 226
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-2988
Country : US
Telephone Number : 706-653-2889
Fax Number : 706-494-8220
Provider Business Practice Location Address
First Line : 1200 BROOKSTONE CENTRE PKWY STE 226
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-2988
Country : US
Telephone Number : 706-653-2889
Fax Number : 706-494-8220
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2017
Last Update Date : 10/31/2025

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