Provider Demographics
NPI:1720460033
Name:MYHRE, YILIA (FNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:YILIA
Middle Name:
Last Name:MYHRE
Suffix:
Gender:F
Credentials:FNP, PMHNP
Other - Prefix:
Other - First Name:YILIA
Other - Middle Name:L
Other - Last Name:MYHRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP, PMHNP
Mailing Address - Street 1:4236 N VERRADO WAY STE A-101
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-7594
Mailing Address - Country:US
Mailing Address - Phone:623-248-1682
Mailing Address - Fax:
Practice Address - Street 1:4236 N VERRADO WAY STE A-101
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-7594
Practice Address - Country:US
Practice Address - Phone:623-248-1682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP77908363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily