Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 310141 | LA |
N | 207U00000X | Nuclear Medicine Specialist | 51564 | AZ |
N | 207U00000X | Nuclear Medicine Specialist | C55859 | CA |
Y | 207U00000X | Nuclear Medicine Specialist | E5304 | AR |
N | 207U00000X | Nuclear Medicine Specialist | ME100797 | FL |
N | 207U00000X | Nuclear Medicine Specialist | P7872 | TX |
NPI | 1275670358 |
---|---|
Provider Name | Tracy Lynnette Yarbrough |
First Address | Little Rock, AR 72223-0007 |
Second Address | Little Rock, AR 72223-9568 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 18/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
166002001 | (05) | AR |
P00405164 | RAILROAD MEDICARE (01) | AR |