Basic Information
| Provider Information | |||||||||
| NPI: | 1205329257 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YATES | ||||||||
| FirstName: | ERIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7580 BUCKINGHAM BLVD STE 220 | ||||||||
| Address2: | |||||||||
| City: | HANOVER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210763210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107295100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11055 LITTLE PATUXENT PKWY STE 104 | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210443234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107402900 | ||||||||
| FaxNumber: | 4109920732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2018 | ||||||||
| LastUpdateDate: | 12/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | R206733 | MD | N | Nursing Service Providers | Registered Nurse | 363L00000X | R206733 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.