Provider Demographics
NPI:1558578138
Name:YODER, KARLA KAY (PA)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:KAY
Last Name:YODER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1322
Mailing Address - Country:US
Mailing Address - Phone:419-423-0424
Mailing Address - Fax:
Practice Address - Street 1:1725 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1322
Practice Address - Country:US
Practice Address - Phone:419-423-0424
Practice Address - Fax:419-423-0641
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1753363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP74445Medicare UPIN
OHKEPA20131Medicare ID - Type Unspecified