Provider Demographics
NPI:1063495109
Name:YOST, ELIZABETH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:YOST
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 E ALMOND AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5752
Mailing Address - Country:US
Mailing Address - Phone:559-674-0917
Mailing Address - Fax:559-674-3104
Practice Address - Street 1:363 E ALMOND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5752
Practice Address - Country:US
Practice Address - Phone:559-674-0917
Practice Address - Fax:559-674-3104
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15787363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA64338OtherPHN #
CA15787OtherSTATE NP #
CA15787OtherNP FURNISHING #
F0605263OtherAANP NATIONAL CERTIFICATI
CA586121OtherCA RN #
CAMY1417117OtherDEA NUMBER