Provider Demographics
NPI:1801245337
Name:YARNOLD, ELISSA M (DO)
Entity type:Individual
Prefix:
First Name:ELISSA
Middle Name:M
Last Name:YARNOLD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48811-9693
Mailing Address - Country:US
Mailing Address - Phone:989-584-3131
Mailing Address - Fax:
Practice Address - Street 1:406 E ELM ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:MI
Practice Address - Zip Code:48811-9693
Practice Address - Country:US
Practice Address - Phone:989-584-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101022589207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine