Provider Demographics
NPI:1629592803
Name:YINGST, KARLY (NP)
Entity Type:Individual
Prefix:
First Name:KARLY
Middle Name:
Last Name:YINGST
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 1:1352 WATERFALL ST
Mailing Address - Street 2:
Mailing Address - City:TIMNATH
Mailing Address - State:CO
Mailing Address - Zip Code:80547-4445
Mailing Address - Country:US
Mailing Address - Phone:970-391-0195
Mailing Address - Fax:
Practice Address - Street 1:1352 WATERFALL ST
Practice Address - Street 2:
Practice Address - City:TIMNATH
Practice Address - State:CO
Practice Address - Zip Code:80547-4445
Practice Address - Country:US
Practice Address - Phone:970-391-0195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO993204363LP0200X
CO0993204363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics