Provider Demographics
NPI:1558698878
Name:YEAROUT, KRISTI (NP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:YEAROUT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65-1267 KAWAIHAE RD
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-7345
Mailing Address - Country:US
Mailing Address - Phone:808-881-4658
Mailing Address - Fax:808-881-4684
Practice Address - Street 1:65-1267 KAWAIHAE ROAD
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743
Practice Address - Country:US
Practice Address - Phone:808-881-4658
Practice Address - Fax:808-881-4684
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI72342163W00000X
HI1475363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse