Provider Demographics
NPI:1437876042
Name:YOKOM, BRENNA ANN
Entity Type:Individual
Prefix:
First Name:BRENNA
Middle Name:ANN
Last Name:YOKOM
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 1:1706 9TH ST N APT 202
Mailing Address - Street 2:
Mailing Address - City:WAHPETON
Mailing Address - State:ND
Mailing Address - Zip Code:58075-3218
Mailing Address - Country:US
Mailing Address - Phone:701-840-7472
Mailing Address - Fax:
Practice Address - Street 1:1321 5TH ST NE APT 101
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-6567
Practice Address - Country:US
Practice Address - Phone:701-840-7472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant