Provider Demographics
NPI:1962635425
Name:PEREZ-SHULMAN, YOLANDA ANN (NP)
Entity Type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:ANN
Last Name:PEREZ-SHULMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVE.
Mailing Address - Street 2:YAMINS 219
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-667-3364
Mailing Address - Fax:617-667-5013
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:YAMINS 219
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-3364
Practice Address - Fax:617-667-5013
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN280794363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110084136AMedicaid
MA001434201Medicare PIN