Provider Demographics
NPI:1962771980
Name:YEAGER, AMARA CHRISTINE (RN)
Entity type:Individual
Prefix:MS
First Name:AMARA
Middle Name:CHRISTINE
Last Name:YEAGER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 FARIBAULT CT
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-4312
Mailing Address - Country:US
Mailing Address - Phone:952-250-6303
Mailing Address - Fax:
Practice Address - Street 1:1732 FARIBAULT CT
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-4312
Practice Address - Country:US
Practice Address - Phone:952-250-6303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR144382-8163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse