Individual provider Active NPI

Deborah Kay Yackuboskey, CRNP, MSN

  • Family Nurse Practitioner
  • Indiana, PA
National Provider Identifier
1093043093
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TP005972W Issued in PA
Practice address
645 Kolter Dr
Indiana, PA 15701-3570
Phone
(724) 349-1111
NPI assigned
Dec 2, 2009
Last updated
Dec 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X TP005972W PA Primary

Addresses

Primary practice location

645 Kolter Dr
Indiana, PA 15701-3570

Mailing address

645 Kolter Dr
Indiana, PA 15701-3570
Phone (724) 349-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
TP005972WPAMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259712000000",
    "number": "1093043093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 KOLTER DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013570",
            "telephone_number": "724-349-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 KOLTER DR",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013570",
            "telephone_number": "724-349-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YACKUBOSKEY",
        "first_name": "DEBORAH",
        "middle_name": "KAY",
        "credential": "CRNP, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-02",
        "last_updated": "2009-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "TP005972W",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.