Individual
JEANNE YEAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
11050 MOUNT BELVEDERE BLVD, FORT DRUM, NY 13602-5438
(315) 772-0859
Mailing address
261 TENEYCK ST, APT 5, WATERTOWN, NY 13601-3902
(315) 782-0491
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085-002033
IL
Other
Enumeration date
12/27/2005
Last updated
12/03/2012
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