Provider Demographics
NPI:1912595547
Name:YELEY, JESSICA RENE (MSN,APRN,FNP-BC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RENE
Last Name:YELEY
Suffix:
Gender:F
Credentials:MSN,APRN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 HIGHWAY HH
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-5368
Mailing Address - Country:US
Mailing Address - Phone:573-727-9130
Mailing Address - Fax:573-727-9128
Practice Address - Street 1:2002 KANELL BLVD
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-4011
Practice Address - Country:US
Practice Address - Phone:573-727-9130
Practice Address - Fax:573-727-9128
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016003492163W00000X
MO2021001528363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily