Individual
MRS. NATALIA GORDILLO YEALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1826DT
KY
152W00000X
Optometrist
2833
CO
152W00000X
Optometrist
OD00004063
WA
152W00000X
Optometrist
Primary
OEG002732
PA
152W00000X
Optometrist
OPC 4281
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12201642
CAQH
—
Enumeration date
10/11/2006
Last updated
05/06/2019
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