Basic Information
Provider Information
NPI: 1265620850
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YARBER
FirstName: BRENDA
MiddleName: MARKHAM
NamePrefix: MRS.
NameSuffix:  
Credential: RN, BSN, CNNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3300 RIVERMONT AVE
Address2:  
City: LYNCHBURG
State: VA
PostalCode: 245032030
CountryCode: US
TelephoneNumber: 4342004555
FaxNumber: 4342004590
Practice Location
Address1: 3300 RIVERMONT AVE
Address2:  
City: LYNCHBURG
State: VA
PostalCode: 245032030
CountryCode: US
TelephoneNumber: 4342004555
FaxNumber: 4342004590
Other Information
ProviderEnumerationDate: 10/09/2007
LastUpdateDate: 10/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LN0000X0024093853VAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal

No ID Information.


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