Individual
DUSTIN RICHARD YODER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 STATE ST, ERIE, PA 16550-0002
(814) 877-2938
Mailing address
912 W 23RD ST, ERIE, PA 16502-2421
(814) 664-0783
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN719106
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN719106
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN719106
PA RN LICENSE
—
Enumeration date
03/22/2023
Last updated
02/12/2024
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