Individual
IRA YEDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1645 E ROOSEVELT ST, PHOENIX, AZ 85006-3638
(602) 372-1718
Mailing address
17712 25TH AVE NE, LAKE FOREST PARK, WA 98155-5211
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
TAP3666
AZ
367A00000X
Advanced Practice Midwife
Primary
TAP3666
AZ
Other
Enumeration date
04/20/2007
Last updated
05/27/2010
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