Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 71008614A | IN |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 71008614A | IN |
NPI | 1003390287 |
---|---|
Provider Name | Caitlin N Yoder |
First Address | Fort Wayne, IN 46845-1703 |
Second Address | Auburn, IN 46706-2013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2018 |
Last Update Date | 31/01/2020 |