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NPI Code Detail

MEDICARE: JENNIFER YATES APNP

MEDICARE: JENNIFER YATES APNP
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
1363L00000XNurse Practitioner3775-33WI

General Provider Information

NPI Number : 1649477175
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER YATES APNP
Provider Business Mailing Address
First Line : 119 E BELL ST
Second Line :
City : NEENAH
State : WI
Zip : 54956-4993
Country : US
Telephone Number : 920-969-1768
Fax Number : 920-267-5222
Provider Business Practice Location Address
First Line : 119 E BELL ST
Second Line :
City : NEENAH
State : WI
Zip : 54956-4993
Country : US
Telephone Number : 920-969-1768
Fax Number : 920-267-5222
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2007
Last Update Date : 04/13/2026

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