Provider Demographics
NPI:1669670444
Name:WHITE, YARA ROBERTA BEEX (PA-C)
Entity type:Individual
Prefix:
First Name:YARA
Middle Name:ROBERTA BEEX
Last Name:WHITE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 VANDERBILT PARK DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1700
Mailing Address - Country:US
Mailing Address - Phone:828-258-0397
Mailing Address - Fax:828-258-3390
Practice Address - Street 1:4 VANDERBILT PARK DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1700
Practice Address - Country:US
Practice Address - Phone:828-258-0397
Practice Address - Fax:828-258-3390
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPENDING363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2770552Medicare PIN