Basic Information
Provider Information
NPI: 1245726934
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YANKEY
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14527 7TH ST
Address2:  
City: DADE CITY
State: FL
PostalCode: 335233102
CountryCode: US
TelephoneNumber: 8667621743
FaxNumber: 7278161222
Practice Location
Address1: 14527 7TH ST
Address2:  
City: DADE CITY
State: FL
PostalCode: 335233102
CountryCode: US
TelephoneNumber: 8667621743
FaxNumber: 7278161222
Other Information
ProviderEnumerationDate: 07/05/2018
LastUpdateDate: 07/18/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN9358375FLN Nursing Service ProvidersRegistered Nurse 
363LP0808XAPRN11018556FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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