Provider Demographics
NPI:1326465667
Name:YATES, ANDREA SPORCK
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:SPORCK
Last Name:YATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 23RD AVE N
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1513
Mailing Address - Country:US
Mailing Address - Phone:615-321-4740
Mailing Address - Fax:615-320-0240
Practice Address - Street 1:345 23RD AVE N
Practice Address - Street 2:SUITE 401
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1513
Practice Address - Country:US
Practice Address - Phone:615-321-4740
Practice Address - Fax:615-320-0240
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18402363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health