Provider Demographics
NPI:1083293641
Name:LO, YEU MELISSA (NP)
Entity Type:Individual
Prefix:
First Name:YEU
Middle Name:MELISSA
Last Name:LO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 N 1ST ST STE 106
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-5628
Mailing Address - Country:US
Mailing Address - Phone:559-890-6111
Mailing Address - Fax:559-892-0321
Practice Address - Street 1:3727 N 1ST ST STE 106
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-5628
Practice Address - Country:US
Practice Address - Phone:559-890-6111
Practice Address - Fax:559-892-0321
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA623462163W00000X
CA95018176363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse