Provider Demographics
NPI:1104037225
Name:YOUSEY, YVONNE K (RN, CPNP, PHD)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:K
Last Name:YOUSEY
Suffix:
Gender:F
Credentials:RN, CPNP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:CO
Mailing Address - Zip Code:80620-1011
Mailing Address - Country:US
Mailing Address - Phone:970-353-9403
Mailing Address - Fax:970-353-9906
Practice Address - Street 1:100 N 11TH AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-2011
Practice Address - Country:US
Practice Address - Phone:970-352-8898
Practice Address - Fax:970-351-7075
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO44443363LP0200X
CO0001257363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07444433Medicaid