Provider Demographics
NPI:1992010045
Name:YEAROUT, PATRICIA LYNN (RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:YEAROUT
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 1:5644 RAFFERTY AVE
Mailing Address - Street 2:
Mailing Address - City:MCCLELLAN
Mailing Address - State:CA
Mailing Address - Zip Code:95652
Mailing Address - Country:US
Mailing Address - Phone:916-830-1511
Mailing Address - Fax:
Practice Address - Street 1:3230 PEACEKEEPER WAY
Practice Address - Street 2:BLDG 209
Practice Address - City:MCCLELLAN
Practice Address - State:CA
Practice Address - Zip Code:95652
Practice Address - Country:US
Practice Address - Phone:916-830-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR853425163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse