Provider Demographics
NPI:1558358879
Name:YARNALL, ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:YARNALL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 GEMINI ST
Mailing Address - Street 2:SUITE #128
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2746
Mailing Address - Country:US
Mailing Address - Phone:713-417-4216
Mailing Address - Fax:281-218-9534
Practice Address - Street 1:1002 GEMINI ST
Practice Address - Street 2:SUITE #128
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2746
Practice Address - Country:US
Practice Address - Phone:713-417-4216
Practice Address - Fax:281-218-9534
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA032613367500000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11803097OtherCAQH
PA1627621OtherHIGHMARK
PA50038394OtherCAPITAL ADVANTAGE
PA1545070OtherGATEWAY
PA2000530OtherKHP CENTRAL
PA9601428OtherAETNA
PA1627621OtherFIRST PRIORITY
PA87062OtherGEISINGER
PA1009797640002Medicaid
PA2303831000OtherINDEP. BLUE CROSS
PA1627621OtherFIRST PRIORITY
PA2000530OtherKHP CENTRAL
PA2303831000OtherINDEP. BLUE CROSS