Basic Information
| Provider Information | |||||||||
| NPI: | 1952400657 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YARNALL | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DC | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 600 PLAZA CT | ||||||||
| Address2: | |||||||||
| City: | EAST STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183018263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704217020 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 600 PLAZA CT | ||||||||
| Address2: | |||||||||
| City: | EAST STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183018263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705170511 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 04/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 04/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | DC007587L | PA | Y | Chiropractic Providers | Chiropractor |
ID Information
| ID | Type | State | Issuer | Description | 0017615820001 | 05 | PA | MEDICAID | 800017119 | 01 | PA | ASHN | OTHER | 60937 | 01 | PA | GEISNGER | OTHER | FI595237 | 01 | PA | BLUE CROSS | OTHER | P3399574 | 01 | PA | OXFORD | OTHER | 7185168 | 01 | PA | AETNA | OTHER | 814648 | 01 | PA | FIRST PRIORITY HEALTH | OTHER |