Provider Demographics
NPI:1952332223
Name:YATES, KAREE MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:KAREE
Middle Name:MICHELLE
Last Name:YATES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:801-235-7246
Mailing Address - Fax:
Practice Address - Street 1:412 W 800 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-3728
Practice Address - Country:US
Practice Address - Phone:801-235-7246
Practice Address - Fax:801-226-4098
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT362482-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT005734310Medicare ID - Type Unspecified
UTQ61467Medicare UPIN