MEDICARE: YOLANDA DEVEREAUX CNM

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	367A00000X	Advanced Practice Midwife	CNM306421	GA
2	367A00000X	Advanced Practice Midwife	235745	CA

General Provider Information

NPI Number	:	1548638786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA DEVEREAUX CNM

Provider Business Mailing Address
First Line	:	2400 MOUNT ZION PKWY
Second Line	:
City	:	JONESBORO
State	:	GA
Zip	:	30236-2500
Country	:	US
Telephone Number	:	404-365-0966
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 MOUNT ZION PKWY
Second Line	:
City	:	JONESBORO
State	:	GA
Zip	:	30236-2500
Country	:	US
Telephone Number	:	404-365-0966
Fax Number	:

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

Provider Enumeration Date	:	09/04/2015
Last Update Date	:	03/12/2026

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