Provider Demographics
NPI:1831642388
Name:MARTIN-THOMAS, YORBALICA (NP)
Entity Type:Individual
Prefix:
First Name:YORBALICA
Middle Name:
Last Name:MARTIN-THOMAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:YORBALICA
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3070 NORTH 51ST STREET
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210
Mailing Address - Country:US
Mailing Address - Phone:414-445-6520
Mailing Address - Fax:414-445-6875
Practice Address - Street 1:3070 N 51ST ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53210-1645
Practice Address - Country:US
Practice Address - Phone:414-445-6520
Practice Address - Fax:414-445-6875
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI157394-30163W00000X
WI7137-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse