Provider Demographics
NPI:1588722235
Name:YORKOVICH, JERRIANN (APRN)
Entity type:Individual
Prefix:
First Name:JERRIANN
Middle Name:
Last Name:YORKOVICH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20375 W 151ST ST STE 301
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7207
Mailing Address - Country:US
Mailing Address - Phone:913-390-8050
Mailing Address - Fax:913-390-8049
Practice Address - Street 1:20375 W 151ST ST STE 301
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7207
Practice Address - Country:US
Practice Address - Phone:913-390-8050
Practice Address - Fax:913-390-8049
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS155196363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSV01138Medicare UPIN
KSR45D158Medicare ID - Type Unspecified