Provider Demographics
NPI:1922346246
Name:YELLE, SUSAN ANN (NP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANN
Last Name:YELLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 MAPLEHURST PT
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-5613
Mailing Address - Country:US
Mailing Address - Phone:720-480-0670
Mailing Address - Fax:
Practice Address - Street 1:212 MAPLEHURST PT
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-5613
Practice Address - Country:US
Practice Address - Phone:720-480-0670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004592363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal