Provider Demographics
NPI:1659162238
Name:YAKE, SHELBY LYNN (MSED, CHW-C, TTS)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LYNN
Last Name:YAKE
Suffix:
Gender:F
Credentials:MSED, CHW-C, TTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 E DANIELS ST
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-8837
Mailing Address - Country:US
Mailing Address - Phone:417-830-0999
Mailing Address - Fax:
Practice Address - Street 1:504 WEST BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:AVA
Practice Address - State:MO
Practice Address - Zip Code:65608
Practice Address - Country:US
Practice Address - Phone:417-683-5739
Practice Address - Fax:417-683-1602
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator