Individual
MS. DIANE J YASTRUB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9937 E HIDDEN TREASURE CT, GOLD CANYON, AZ 85118-5876
(516) 313-5563
Mailing address
9937 E HIDDEN TREASURE CT, GOLD CANYON, AZ 85118-5876
(516) 313-5563
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
235723
AZ
363LF0000X
Family Nurse Practitioner
F332974-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02077645
—
NY
01
—
P2374172
OXFORD PROVIDER NUMBER
NY
Enumeration date
09/27/2005
Last updated
04/08/2020
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