Individual
KATELYN ELAINE YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
111 LOVETT DR, GREENVILLE, SC 29607-6510
(801) 869-4100
(208) 869-4119
Mailing address
1481 CENTER STREET EXT APT 804, MOUNT PLEASANT, SC 29464-4652
(757) 371-5458
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5805
SC
Other
Enumeration date
03/27/2025
Last updated
04/10/2025
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