Provider Demographics
NPI:1710399852
Name:YOST, KIMBERLY ANN (MS, ATC, CSCS)
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:ANN
Last Name:YOST
Suffix:
Gender:F
Credentials:MS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ELMCROFT CT
Mailing Address - Street 2:APT. D107
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5860
Mailing Address - Country:US
Mailing Address - Phone:301-655-8795
Mailing Address - Fax:
Practice Address - Street 1:21 ELMCROFT CT
Practice Address - Street 2:APT. D107
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5860
Practice Address - Country:US
Practice Address - Phone:301-655-8795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA0003912255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer