Provider Demographics
NPI:1447569363
Name:YORKE, GLORY JANE ADER (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:GLORY JANE
Middle Name:ADER
Last Name:YORKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10616 TRANQUIL GLADE LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1216
Mailing Address - Country:US
Mailing Address - Phone:808-753-1838
Mailing Address - Fax:
Practice Address - Street 1:4100 W FLAMINGO RD STE 2100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3926
Practice Address - Country:US
Practice Address - Phone:702-822-5000
Practice Address - Fax:702-822-5001
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21058363A00000X
NVPA1286363AM0700X
NVPA0246363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant