Provider Demographics
NPI:1851828743
Name:BROWN-YARSIAH, QUETTA WILCELIA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:QUETTA
Middle Name:WILCELIA
Last Name:BROWN-YARSIAH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 S ELM AVE
Mailing Address - Street 2:
Mailing Address - City:ALDAN
Mailing Address - State:PA
Mailing Address - Zip Code:19018-4107
Mailing Address - Country:US
Mailing Address - Phone:484-557-3972
Mailing Address - Fax:
Practice Address - Street 1:38 S ELM AVE
Practice Address - Street 2:
Practice Address - City:ALDAN
Practice Address - State:PA
Practice Address - Zip Code:19018-4107
Practice Address - Country:US
Practice Address - Phone:484-557-3972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016734363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily