Provider Demographics
NPI:1770040503
Name:LAMPHIER, YVONNE YOUNG
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:YOUNG
Last Name:LAMPHIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9941 S BLOCK RD
Mailing Address - Street 2:
Mailing Address - City:BIRCH RUN
Mailing Address - State:MI
Mailing Address - Zip Code:48415-9279
Mailing Address - Country:US
Mailing Address - Phone:989-928-4974
Mailing Address - Fax:
Practice Address - Street 1:9941 S BLOCK RD
Practice Address - Street 2:
Practice Address - City:BIRCH RUN
Practice Address - State:MI
Practice Address - Zip Code:48415-9279
Practice Address - Country:US
Practice Address - Phone:989-928-4974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703106603164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4703106603OtherNURSE'S LICENSE