Provider Demographics
NPI:1477863744
Name:SHAMES, YANINA V, (PNP)
Entity Type:Individual
Prefix:MS
First Name:YANINA
Middle Name:V,
Last Name:SHAMES
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4901 E 5TH ST
Mailing Address - Street 2:CODAC
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2203
Mailing Address - Country:US
Mailing Address - Phone:520-318-9222
Mailing Address - Fax:520-318-9049
Practice Address - Street 1:4901 E 5TH ST
Practice Address - Street 2:CODAC
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2203
Practice Address - Country:US
Practice Address - Phone:520-318-9222
Practice Address - Fax:520-318-9049
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAP3829363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health