Provider Demographics
NPI:1285043752
Name:YOST, NICHOLE (CNP,FNP-BC)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:YOST
Suffix:
Gender:F
Credentials:CNP,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5622 SHERIDAN LAKE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-8881
Mailing Address - Country:US
Mailing Address - Phone:605-354-1734
Mailing Address - Fax:605-791-1849
Practice Address - Street 1:5622 SHERIDAN LAKE RD STE 105
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-8881
Practice Address - Country:US
Practice Address - Phone:605-787-2170
Practice Address - Fax:605-791-1849
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP001507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily