Basic Information
| Provider Information | |||||||||
| NPI: | 1023491099 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YARBROUGH | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 850 N HOSPITAL DR | ||||||||
| Address2: | SUITE F | ||||||||
| City: | FULTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652512535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5736425338 | ||||||||
| FaxNumber: | 5736429224 | ||||||||
| Practice Location | |||||||||
| Address1: | 850 N HOSPITAL DR | ||||||||
| Address2: | SUITE F | ||||||||
| City: | FULTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652512535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5736425338 | ||||||||
| FaxNumber: | 5736429224 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2015 | ||||||||
| LastUpdateDate: | 07/08/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 2015008058 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.