Provider Demographics
NPI:1093424889
Name:YEO, INYOUNG STELLA (PA)
Entity Type:Individual
Prefix:
First Name:INYOUNG
Middle Name:STELLA
Last Name:YEO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:STELLA
Other - Middle Name:
Other - Last Name:YEO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:4535 DRESSLER RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2545
Mailing Address - Country:US
Mailing Address - Phone:330-493-4443
Mailing Address - Fax:
Practice Address - Street 1:1850 TOWN CENTER PKWY
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3204
Practice Address - Country:US
Practice Address - Phone:703-689-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant