Provider Demographics
NPI:1306152285
Name:YETZER, JUDY ANN (CNP)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN
Last Name:YETZER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W STRUB RD
Mailing Address - Street 2:330
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-5390
Mailing Address - Country:US
Mailing Address - Phone:419-626-6700
Mailing Address - Fax:
Practice Address - Street 1:16712 PEARL RD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-6049
Practice Address - Country:US
Practice Address - Phone:440-238-0360
Practice Address - Fax:440-238-8835
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 11600 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily