Provider Demographics
NPI:1851075808
Name:YARRI, PHILIP CHARLES JR (FNP-C)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:CHARLES
Last Name:YARRI
Suffix:JR
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 WOODLAKE DR
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-1971
Mailing Address - Country:US
Mailing Address - Phone:770-846-8897
Mailing Address - Fax:
Practice Address - Street 1:69 WOODLAKE DR
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1971
Practice Address - Country:US
Practice Address - Phone:770-846-8897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF05231213363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner