Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | R189805 | MD |
NPI | 1003235581 |
---|---|
Provider Name | Laurie Katherine Yancey |
First Address | Cheverly, MD 20785-1189 |
Second Address | Cheverly, MD 20785-1189 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2014 |
Last Update Date | 10/09/2014 |