Individual
AUDRA L YENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10 TOWER DR, SUN PRAIRIE, WI 53590-1239
(608) 825-3008
(608) 825-3786
Mailing address
10 TOWER DR, SUN PRAIRIE, WI 53590-1239
(608) 825-3008
(608) 825-3786
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
652-23
WI
363AM0700X
Medical Physician Assistant
652-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356392237
—
WI
Enumeration date
05/15/2006
Last updated
12/23/2020
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