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Individual

MISS DORCAS ANN YATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN CFNP

Contact information

Practice address
1010 E ROOSEVELT AVE, GRANTS, NM 87020-2118
(505) 287-2948
(505) 287-5372
Mailing address
1010 E ROOSEVELT AVE, GRANTS, NM 87020-2118
(505) 287-2948
(505) 287-5372

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R15456
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
44636
NM
01
85-0286828
FEDERAL TAX ID
NM
05
G0667
NM
Enumeration date
02/08/2006
Last updated
12/07/2010
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