Provider Demographics
NPI:1376094995
Name:YATES, DEANNA (CRNP)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:YATES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:
Other - Last Name:PAPAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-2200
Mailing Address - Fax:484-526-2398
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:484-526-2200
Practice Address - Fax:484-526-2398
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN607191363L00000X
PASP016647363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner