Provider Demographics
NPI:1881263366
Name:YATH, STEVEN (RN)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:YATH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 HUNTERS CT
Mailing Address - Street 2:
Mailing Address - City:EAGLE LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56024-7602
Mailing Address - Country:US
Mailing Address - Phone:507-779-4561
Mailing Address - Fax:
Practice Address - Street 1:208 HUNTERS CT
Practice Address - Street 2:
Practice Address - City:EAGLE LAKE
Practice Address - State:MN
Practice Address - Zip Code:56024-7602
Practice Address - Country:US
Practice Address - Phone:507-779-4561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2487418163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse