Provider Demographics
NPI:1326498304
Name:YAHNKE, SHARON KAY
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:KAY
Last Name:YAHNKE
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 1:709 OHIO ST # 604
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:IA
Mailing Address - Zip Code:51652-8057
Mailing Address - Country:US
Mailing Address - Phone:712-374-2093
Mailing Address - Fax:712-374-2093
Practice Address - Street 1:709 OHIO ST # 604
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:IA
Practice Address - Zip Code:51652-8057
Practice Address - Country:US
Practice Address - Phone:712-374-2093
Practice Address - Fax:712-374-2093
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA165AC6540172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver