Provider Demographics
NPI:1235266180
Name:YARDLEY, JANETTE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JANETTE
Middle Name:
Last Name:YARDLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 JOHNSTON PKWY
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-8320
Mailing Address - Country:US
Mailing Address - Phone:816-341-1046
Mailing Address - Fax:
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:816-234-3040
Practice Address - Fax:816-302-9896
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYMY1549522363AM0700X
MO2008031590363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical