Provider Demographics
NPI:1346679842
Name:MATTHEWS, YAMINAH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:YAMINAH
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:YAMINAH
Other - Middle Name:
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:651 BANDERA DR
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75167-1244
Mailing Address - Country:US
Mailing Address - Phone:336-341-9295
Mailing Address - Fax:
Practice Address - Street 1:1007 LEGACY RANCH RD STE 102
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1294
Practice Address - Country:US
Practice Address - Phone:972-666-8111
Practice Address - Fax:949-437-8422
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC001233363LF0000X
NC5006882363LF0000X
TXAP133794363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner