Basic Information
| Provider Information | |||||||||
| NPI: | 1578942066 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YATES | ||||||||
| FirstName: | JAMES | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1204 DAVIS ST | ||||||||
| Address2: | |||||||||
| City: | CONWAY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 720343917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733561566 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8060 COUNTS MASSIE RD | ||||||||
| Address2: | |||||||||
| City: | MAUMELLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721136657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5017910198 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2015 | ||||||||
| LastUpdateDate: | 05/29/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | A004230 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.