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NPI Code Detail

MEDICARE: LISA L YARGER CFNP

MEDICARE: LISA L YARGER CFNP
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
1363LF0000XFamily Nurse Practitioner71000374AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000835186OTHERANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548232259
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA L YARGER CFNP
Provider Business Mailing Address
First Line : 330 N WABASH AVE STE G-20
Second Line :
City : MARION
State : IN
Zip : 46952-2605
Country : US
Telephone Number : 765-660-7600
Fax Number : 765-651-7313
Provider Business Practice Location Address
First Line : 5693 YMCA PARK DR W
Second Line :
City : FORT WAYNE
State : IN
Zip : 46835-3280
Country : US
Telephone Number : 260-425-6500
Fax Number : 260-425-6505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 09/05/2024

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