Individual
SANDRA YAZELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4764 STATE ROUTE 321, HILLSBORO, OH 45133-8892
(937) 217-4083
Mailing address
4764 STATE ROUTE 321, HILLSBORO, OH 45133-8892
(937) 217-4083
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400609640407
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3087109
OHIO MEDICAID INDEPENDENT PROVIDER NUMBER
OH
Enumeration date
03/24/2011
Last updated
03/24/2011
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