Individual
MS. SALLY J. YODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
68 FENNER AVENUE, TROY, PA 16947-1501
(570) 297-4104
(570) 297-2066
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F340238-1
NY
363L00000X
Nurse Practitioner
Primary
VP003382H
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01734078
—
NY
01
—
500001497
RR MEDICARE PIN
PA
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU040074
PA MEDICARE GROUP
PA
Enumeration date
02/28/2006
Last updated
09/19/2011
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