Provider Demographics
NPI:1730156522
Name:GAYHART, YVONNE LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:LYNN
Last Name:GAYHART
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 W MAIN CROSS ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-2423
Mailing Address - Country:US
Mailing Address - Phone:419-424-1393
Mailing Address - Fax:419-424-3424
Practice Address - Street 1:1110 W MAIN CROSS ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-2423
Practice Address - Country:US
Practice Address - Phone:419-424-1393
Practice Address - Fax:419-424-3424
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50001712363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH50001712OtherOHIO STATE LICENSE
OHGAPA19501Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
OH50001712OtherOHIO STATE LICENSE