Individual
KIM A YEAKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
2120 N CENTRAL AVE, PHOENIX, AZ 85004-1455
(602) 933-6100
(602) 933-2422
Mailing address
3200 E CAMELBACK RD, STE 250, PHOENIX, AZ 85018-2327
(602) 933-1814
(602) 933-1820
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP2112
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412012
—
AZ
Enumeration date
11/24/2008
Last updated
06/17/2021
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