Provider Demographics
NPI:1982484242
Name:YAUL, LINDA VANESSA (ACNP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:VANESSA
Last Name:YAUL
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HIDDEN HILLS CIR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-4541
Mailing Address - Country:US
Mailing Address - Phone:931-561-9949
Mailing Address - Fax:
Practice Address - Street 1:7048 OLD CANTON RD STE 2E
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-1021
Practice Address - Country:US
Practice Address - Phone:601-919-0972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906270363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care