Provider Demographics
NPI:1376341867
Name:YOAK, NICOLE EVELYN
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:EVELYN
Last Name:YOAK
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 1:753 BIG SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26178-6502
Mailing Address - Country:US
Mailing Address - Phone:304-299-4505
Mailing Address - Fax:
Practice Address - Street 1:2828 OLD ROUTE 33
Practice Address - Street 2:
Practice Address - City:HORNER
Practice Address - State:WV
Practice Address - Zip Code:26372-9705
Practice Address - Country:US
Practice Address - Phone:304-269-4556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV41052164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse