Provider Demographics
NPI:1467833459
Name:YEICH, EDWARD (CRNP, FNP)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:YEICH
Suffix:
Gender:M
Credentials:CRNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 N DUKE ST APT 5J
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2061
Mailing Address - Country:US
Mailing Address - Phone:717-925-0024
Mailing Address - Fax:
Practice Address - Street 1:728 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2020
Practice Address - Country:US
Practice Address - Phone:717-625-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002513363LF0000X
PASP016031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily