Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 19440 | AZ |
NPI | 1124124193 |
---|---|
Provider Name | Stacey L Yell |
First Address | Tucson, AZ 85704-7870 |
Second Address | Tucson, AZ 85704-7870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 13/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
410126 | (05) | AZ |
E66799 | (02) | AZ |