Basic Information
| Provider Information | |||||||||
| NPI: | 1063499358 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YATES | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | YVONNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4078 18TH AVE | ||||||||
| Address2: | |||||||||
| City: | BETTENDORF | ||||||||
| State: | IA | ||||||||
| PostalCode: | 527227156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5633447874 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1227 E RUSHOLME ST | ||||||||
| Address2: | |||||||||
| City: | DAVENPORT | ||||||||
| State: | IA | ||||||||
| PostalCode: | 528032459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5634217681 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 207P00000X | 27600 | IA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.