Individual
JILL YASTISHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-5000
Mailing address
PO BOX 744785, ATLANTA, GA 30374-4785
(202) 476-5000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
22 672826
NY
163W00000X
Registered Nurse
95054780
CA
363LP0200X
Pediatric Nurse Practitioner
95002359
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
RN1057546
DC
390200000X
Student in an Organized Health Care Education/Training Program
22 672826
NY
Other
Enumeration date
07/12/2014
Last updated
10/08/2020
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