Marta B Yakovleva, RN,

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R2297413 Issued in MN

Practice address

3605 104TH Ave N
Brooklyn Park, MN 55443-1015

Phone

(612) 723-6682

NPI assigned

Nov 21, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1750895116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 104TH AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431015",
            "telephone_number": "612-723-6682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 104TH AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431015",
            "telephone_number": "612-723-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKOVLEVA",
        "first_name": "MARTA",
        "middle_name": "B",
        "credential": "RN,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R2297413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Nurse in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.