Provider Demographics
NPI:1023507662
Name:YAUSSY, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:YAUSSY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905-2131
Mailing Address - Country:US
Mailing Address - Phone:419-631-5386
Mailing Address - Fax:
Practice Address - Street 1:623 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905-2131
Practice Address - Country:US
Practice Address - Phone:419-631-5386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7004295376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker