Provider Demographics
NPI:1023089190
Name:YAHL, AGNES MARIE (FNP)
Entity type:Individual
Prefix:MRS
First Name:AGNES
Middle Name:MARIE
Last Name:YAHL
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 1:2001 N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-2338
Mailing Address - Country:US
Mailing Address - Phone:903-577-6000
Mailing Address - Fax:
Practice Address - Street 1:2101 MULBERRY AVE
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-1105
Practice Address - Country:US
Practice Address - Phone:903-434-4850
Practice Address - Fax:903-434-4899
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1342363LF0000X
MO2023013501363LF0000X
TX123643363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ623688Medicaid
P44235Medicare UPIN
AZ623688Medicaid