Provider Demographics
NPI:1619203148
Name:YARDLEY, MICHELLE ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:YARDLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 CATES AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27695-0001
Mailing Address - Country:US
Mailing Address - Phone:919-515-5040
Mailing Address - Fax:919-513-0440
Practice Address - Street 1:2815 CATES AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27695-4849
Practice Address - Country:US
Practice Address - Phone:919-515-5040
Practice Address - Fax:919-513-0440
Is Sole Proprietor?:No
Enumeration Date:2009-10-17
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0070005211835P0018X
NC16907183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0920056Medicaid