Provider Demographics
NPI:1669017869
Name:RESUMA, YURI E (LPN)
Entity Type:Individual
Prefix:MR
First Name:YURI
Middle Name:E
Last Name:RESUMA
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9663
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96931-5663
Mailing Address - Country:US
Mailing Address - Phone:671-649-6877
Mailing Address - Fax:671-647-1606
Practice Address - Street 1:396 CHALAN SAN ANTONIO BRI BLDG.
Practice Address - Street 2:SUITE 102
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-5663
Practice Address - Country:US
Practice Address - Phone:671-649-6877
Practice Address - Fax:671-647-1606
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GULX0614164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse