Individual
MICHELLE EGAR YEASAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
227 FALCON DR STE 104, MT STERLING, KY 40353-9792
(859) 497-5459
(859) 497-5470
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7835
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA055
KY
363AM0700X
Medical Physician Assistant
PA055
KY
363AS0400X
Surgical Physician Assistant
PA055
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37903705
MEDICAID GROUP LAB
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
95005138
—
KY
01
—
CB5773
RR MEDICARE GROUP
KY
01
—
P00245022
RR MEDICARE PIN
KY
Enumeration date
10/05/2006
Last updated
07/03/2019
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