Provider Demographics
NPI:1124138953
Name:YELVERTON, PAULA (APN BOARD CERTIFIED)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:
Last Name:YELVERTON
Suffix:
Gender:F
Credentials:APN BOARD CERTIFIED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 BROWN OWL RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:TN
Mailing Address - Zip Code:37062-7011
Mailing Address - Country:US
Mailing Address - Phone:615-412-5556
Mailing Address - Fax:
Practice Address - Street 1:275 CUMBERLAND BND
Practice Address - Street 2:MENTAL HEALTH COOPERATIVE
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1803
Practice Address - Country:US
Practice Address - Phone:615-743-1528
Practice Address - Fax:615-743-1687
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
3342023Medicare ID - Type Unspecified
R82906Medicare UPIN