Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | A117126 | IA |
NPI | 1003155995 |
---|---|
Provider Name | Alva Eugene Yoder |
First Address | Leon, IA 50144-1206 |
Second Address | Leon, IA 50144-1206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2013 |
Last Update Date | 12/02/2013 |