Provider Demographics
NPI:1184145781
Name:YATES, AMY SUE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:SUE
Last Name:YATES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:SUE
Other - Last Name:OBERHAUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3355 GLENDALE AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2426
Mailing Address - Country:US
Mailing Address - Phone:419-383-7100
Mailing Address - Fax:419-383-2000
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2595
Practice Address - Country:US
Practice Address - Phone:419-383-3588
Practice Address - Fax:419-383-3105
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020731363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily