Provider Demographics
NPI:1326598228
Name:YODER, HENRIETTA
Entity Type:Individual
Prefix:
First Name:HENRIETTA
Middle Name:
Last Name:YODER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RHETTA
Other - Middle Name:
Other - Last Name:YODER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:20771 STATE ROUTE 637
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45873-9045
Mailing Address - Country:US
Mailing Address - Phone:419-393-2117
Mailing Address - Fax:
Practice Address - Street 1:20771 STATE ROUTE 637
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:OH
Practice Address - Zip Code:45873-9045
Practice Address - Country:US
Practice Address - Phone:419-393-2117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide