Provider Demographics
NPI:1487627683
Name:YAFFE, MICHAELINE MARY (CRNP)
Entity type:Individual
Prefix:
First Name:MICHAELINE
Middle Name:MARY
Last Name:YAFFE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16109 MARKOE RD
Mailing Address - Street 2:
Mailing Address - City:MONKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21111-1716
Mailing Address - Country:US
Mailing Address - Phone:443-253-6563
Mailing Address - Fax:
Practice Address - Street 1:16109 MARKOE RD
Practice Address - Street 2:
Practice Address - City:MONKTON
Practice Address - State:MD
Practice Address - Zip Code:21111-1716
Practice Address - Country:US
Practice Address - Phone:443-253-6563
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR070246363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology