Misha Boris Yakovleff, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

064902-21 Issued in NH

Practice address

28 Elm St
Charlestown, NH 03603-5006

Phone

(603) 826-3704

NPI assigned

Jun 26, 2013

Last updated

Jun 26, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1174963805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 ELM ST",
            "city": "CHARLESTOWN",
            "state": "NH",
            "postal_code": "036035006",
            "telephone_number": "603-826-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 ELM ST",
            "city": "CHARLESTOWN",
            "state": "NH",
            "postal_code": "036035006",
            "telephone_number": "603-826-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKOVLEFF",
        "first_name": "MISHA",
        "middle_name": "BORIS",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NH",
            "license": "064902-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "064902-21",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cecilia M Vicuna Keady, ARNP
• Weeks and Gowen Physical Therapy Associates Inc

• Registered Nurse in Charlestown, NH
• Providers in Charlestown, NH by specialty
• Registered Nurse in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.