Provider Demographics
NPI:1114583101
Name:CONAWAY, YVONNE (WHNP)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:CONAWAY
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 GLENN WINKLES DR
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-3348
Mailing Address - Country:US
Mailing Address - Phone:404-667-9748
Mailing Address - Fax:
Practice Address - Street 1:1279 HIGHWAY 54 W STE 100
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4551
Practice Address - Country:US
Practice Address - Phone:770-719-5710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN207040363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN207040OtherADVANCE PRACTICE LICENSE