Provider Demographics
NPI:1700420338
Name:YAUILLA, REBECCA JOANNE (APRN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JOANNE
Last Name:YAUILLA
Suffix:
Gender:F
Credentials:APRN
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 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2534
Mailing Address - Fax:501-748-3334
Practice Address - Street 1:2000 HARRISON ST STE D
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7444
Practice Address - Country:US
Practice Address - Phone:870-569-4290
Practice Address - Fax:870-569-4293
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR122505363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner