Provider Demographics
NPI:1356410203
Name:HAEBERLE, YVETTE M (MD)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:M
Last Name:HAEBERLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10245 ANTELOPE AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-4193
Mailing Address - Country:US
Mailing Address - Phone:308-234-6410
Mailing Address - Fax:
Practice Address - Street 1:10 E. 31 STREET
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-6884
Practice Address - Country:US
Practice Address - Phone:308-865-7997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19872207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine