Basic Information
| Provider Information | |||||||||
| NPI: | 1609334879 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YAKLE | ||||||||
| FirstName: | TREVOR | ||||||||
| MiddleName: | LAURENCE | ||||||||
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| Credential: | NURSE PRACTITIONER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9207 SLATER ST | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662123826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6202288009 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10701 NALL AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662111358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133815225 | ||||||||
| FaxNumber: | 9139010186 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2019 | ||||||||
| LastUpdateDate: | 02/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 2019006490 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 53-78626-122 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.