Individual
DEANA LOUISE YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
1200 N WEST AVE, JACKSON, MI 49202-2179
(517) 796-4590
Mailing address
627 W CANAL ST, TEKONSHA, MI 49092-9795
(517) 796-4590
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
4704226228
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704226228
REGISTERED NURSE
MI
Enumeration date
08/18/2014
Last updated
08/18/2014
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