Provider Demographics
NPI:1497841225
Name:YATES, REBECCA LYNN (CNM)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNN
Last Name:YATES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MS
Other - First Name:BECKY
Other - Middle Name:L
Other - Last Name:YATES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:405 LINDSAY ST
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-4829
Mailing Address - Country:US
Mailing Address - Phone:336-889-6000
Mailing Address - Fax:
Practice Address - Street 1:405 LINDSAY ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4829
Practice Address - Country:US
Practice Address - Phone:336-889-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC176486176B00000X
NC176486CNM174367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7002102Medicaid
NCQ05164Medicare UPIN