Individual
KELLIE K YENRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2940 N MCCORD RD, TOLEDO, OH 43615-1753
(419) 842-3000
(419) 842-3042
Mailing address
2940 N MCCORD RD, TOLEDO, OH 43615-1753
(419) 842-3000
(419) 842-3042
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50003712
OH
363A00000X
Physician Assistant
5601006693
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0080158
—
OH
Enumeration date
02/15/2013
Last updated
11/03/2023
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