Provider Demographics
NPI:1598173189
Name:YANGZOM, NYIMA (FNP-C)
Entity Type:Individual
Prefix:
First Name:NYIMA
Middle Name:
Last Name:YANGZOM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 PFEIFFER RD
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4872
Mailing Address - Country:US
Mailing Address - Phone:513-748-9212
Mailing Address - Fax:
Practice Address - Street 1:5151 PFEIFFER RD
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-4872
Practice Address - Country:US
Practice Address - Phone:513-748-9212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-27
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.15873-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily