Provider Demographics
NPI:1821020439
Name:YODER, ADAM L (MS, BSN, RN)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:L
Last Name:YODER
Suffix:
Gender:M
Credentials:MS, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16760 YEOMAN WAY
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8092
Mailing Address - Country:US
Mailing Address - Phone:317-867-1455
Mailing Address - Fax:
Practice Address - Street 1:8330 ALLISON POINTE TRL
Practice Address - Street 2:AHDI
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1682
Practice Address - Country:US
Practice Address - Phone:317-284-7687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28184984A163W00000X, 163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1821020439Medicare Oscar/Certification