Provider Demographics
NPI:1801823000
Name:YELLEN, AVA NAN (DC)
Entity Type:Individual
Prefix:DR
First Name:AVA
Middle Name:NAN
Last Name:YELLEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8417 E MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257
Mailing Address - Country:US
Mailing Address - Phone:480-946-3399
Mailing Address - Fax:480-946-2559
Practice Address - Street 1:3940 N MILLER RD
Practice Address - Street 2:STE G
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-4539
Practice Address - Country:US
Practice Address - Phone:480-946-3399
Practice Address - Fax:480-946-2559
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4975111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ686925Medicaid
U47212Medicare UPIN
DC4975Medicare ID - Type Unspecified