Provider Demographics
NPI:1386273589
Name:YEARWOOD, MARGARET L. SELENA (APRN, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:MARGARET L.
Middle Name:SELENA
Last Name:YEARWOOD
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14412 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4367
Mailing Address - Country:US
Mailing Address - Phone:602-920-8363
Mailing Address - Fax:
Practice Address - Street 1:14412 N 9TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-4367
Practice Address - Country:US
Practice Address - Phone:602-920-8363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ240073363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health