Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 95012579 | CA |
N | 363L00000X | Nurse Practitioner | APRN.CNP.0029519 | OH |
NPI | 1003457995 |
---|---|
Provider Name | Michael Lawrence Yoder |
First Address | Columbus, OH 43210-1240 |
Second Address | Columbus, OH 43210-1240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2019 |
Last Update Date | 28/10/2021 |