Individual
AMY YEATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
5230 S 6TH STREET RD, SPRINGFIELD, IL 62703-5128
(217) 585-1180
(217) 585-4747
Mailing address
5230 S 6TH STREET RD, SPRINGFIELD, IL 62703-5128
(217) 585-1180
(217) 585-4747
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209013791
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209013791
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041232199
REGISTERED NURSE
IL
01
—
209013791
NURSE PRACTITIONER
IL
Enumeration date
02/03/2016
Last updated
02/21/2017
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