Provider Demographics
NPI:1386280477
Name:YATES, JAYDEN SHI (FNP-C)
Entity type:Individual
Prefix:
First Name:JAYDEN
Middle Name:SHI
Last Name:YATES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 QUAKER RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-4347
Mailing Address - Country:US
Mailing Address - Phone:325-203-6501
Mailing Address - Fax:
Practice Address - Street 1:189 QUAKER RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-4347
Practice Address - Country:US
Practice Address - Phone:325-203-6501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-23
Last Update Date:2019-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144141363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily