Provider Demographics
NPI:1073732152
Name:YANCEY, MARY MILNES (CRNP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:MILNES
Last Name:YANCEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:M
Other - Last Name:YANCEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:333 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3117
Mailing Address - Country:US
Mailing Address - Phone:410-758-0720
Mailing Address - Fax:410-758-0245
Practice Address - Street 1:219 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-2913
Practice Address - Country:US
Practice Address - Phone:410-822-1000
Practice Address - Fax:410-820-7949
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR104582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR104582OtherNURSING LICENSE NUMBER
MDMY0953376OtherDEA
MDMY0953376OtherDEA