Provider Demographics
NPI:1477896280
Name:YATES, TONYA VERNETTE (LPN)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:VERNETTE
Last Name:YATES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 W CENTRAL AVE
Mailing Address - Street 2:E2
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3463
Mailing Address - Country:US
Mailing Address - Phone:419-450-1985
Mailing Address - Fax:419-407-5305
Practice Address - Street 1:2711 W CENTRAL AVE
Practice Address - Street 2:E2
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3463
Practice Address - Country:US
Practice Address - Phone:419-450-1985
Practice Address - Fax:419-407-5305
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN131778 M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse