Provider Demographics
NPI:1215285614
Name:YEARSLEY, CARLIE ANN (CNM, WHNP)
Entity type:Individual
Prefix:MRS
First Name:CARLIE
Middle Name:ANN
Last Name:YEARSLEY
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 S 1300 E
Mailing Address - Street 2:STE. 310
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-3766
Mailing Address - Country:US
Mailing Address - Phone:801-501-3300
Mailing Address - Fax:801-501-3310
Practice Address - Street 1:9600 S 1300 E
Practice Address - Street 2:STE. 310
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-3766
Practice Address - Country:US
Practice Address - Phone:801-501-3300
Practice Address - Fax:801-501-3310
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6558348-4402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife