Provider Demographics
NPI:1942620778
Name:NAM, YURI (NP)
Entity Type:Individual
Prefix:
First Name:YURI
Middle Name:
Last Name:NAM
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 1:505 PARNASSUS AVE
Mailing Address - Street 2:RM M917 ICU/CRITICAL CARE
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2204
Mailing Address - Country:US
Mailing Address - Phone:415-353-1212
Mailing Address - Fax:415-353-5353
Practice Address - Street 1:505 PARNASSUS AVE
Practice Address - Street 2:RM M917 ICU/CRITICAL CARE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2204
Practice Address - Country:US
Practice Address - Phone:415-353-1212
Practice Address - Fax:415-353-5353
Is Sole Proprietor?:No
Enumeration Date:2014-04-19
Last Update Date:2014-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 23724363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care