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Individual

JACQUELINE YOARS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
6335 HOSPITAL PKWY, SUITE 304, JOHNS CREEK, GA 30097-1549
(404) 778-8317
Mailing address
4020 BROOKS BRIDGE XING, ALPHARETTA, GA 30022-4917

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
ARNP9235120
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN256769
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0038303 00
FL
01
G00SR
BCBS
FL
01
P01045892
RAILROAD MEDICARE
01
XXX-XX-7185
CHAMPUS / TRICARE (SOUTH REGION)
Enumeration date
06/18/2011
Last updated
03/28/2019
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