Provider Demographics
NPI:1518919364
Name:YOST, SALLY A (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:A
Last Name:YOST
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:W4171 TAGAY TAY TER
Mailing Address - Street 2:
Mailing Address - City:WAUBEKA
Mailing Address - State:WI
Mailing Address - Zip Code:53021-9789
Mailing Address - Country:US
Mailing Address - Phone:262-692-2942
Mailing Address - Fax:
Practice Address - Street 1:W4171 TAGAY TAY TER
Practice Address - Street 2:
Practice Address - City:WAUBEKA
Practice Address - State:WI
Practice Address - Zip Code:53021-9789
Practice Address - Country:US
Practice Address - Phone:262-692-2942
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI27385-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse