Provider Demographics
NPI:1699469940
Name:YATES, EIRA N
Entity type:Individual
Prefix:
First Name:EIRA
Middle Name:N
Last Name:YATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23710 GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1938
Mailing Address - Country:US
Mailing Address - Phone:216-832-9147
Mailing Address - Fax:
Practice Address - Street 1:23710 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-1938
Practice Address - Country:US
Practice Address - Phone:216-832-9147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health