Basic Information
| Provider Information | |||||||||
| NPI: | 1316439771 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YARRA | ||||||||
| FirstName: | SHRUTI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 523 PARK STREET | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 42101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5029650492 | ||||||||
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| Practice Location | |||||||||
| Address1: | 523 PARK STREET WOMEN'S HEALTH SPECIALISTS | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 42101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707810075 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2018 | ||||||||
| LastUpdateDate: | 10/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | 56175 | KY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.