Provider Demographics
NPI:1184267791
Name:YEAGER, CATHRINE R (FNP-C)
Entity type:Individual
Prefix:
First Name:CATHRINE
Middle Name:R
Last Name:YEAGER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 DAVIDSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1317
Mailing Address - Country:US
Mailing Address - Phone:410-721-3762
Mailing Address - Fax:
Practice Address - Street 1:2003 DAVIDSONVILLE RD
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-1317
Practice Address - Country:US
Practice Address - Phone:410-721-3762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-26
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013121363LF0000X
MDR243062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95013121OtherFURNISHING NUMBER