Basic Information
Provider Information
NPI: 1558560425
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: YASMEEN
MiddleName: J M
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MCPHERSON
OtherFirstName: YASMEEN
OtherMiddleName: J
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNP
OtherLastNameType: 1
Mailing Information
Address1: 213 S JEFFERSON ST STE 1006
Address2:  
City: ROANOKE
State: VA
PostalCode: 240111713
CountryCode: US
TelephoneNumber: 5402245715
FaxNumber: 5402245684
Practice Location
Address1: 3 RIVERSIDE CIR
Address2:  
City: ROANOKE
State: VA
PostalCode: 240164955
CountryCode: US
TelephoneNumber: 5405261550
FaxNumber: 5405261383
Other Information
ProviderEnumerationDate: 07/12/2007
LastUpdateDate: 08/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102X0024169037VAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


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