Theresa A Yazzie, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

L1741 Issued in NM

Practice address

24276 166TH St. Airport Rd
Eagle Butte, SD 57625

Phone

(505) 860-8927

NPI assigned

Mar 26, 2013

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

State licenses

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1891037065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 ELK DRIVE",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "57625",
            "telephone_number": "505-860-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24276 166TH ST. AIRPORT RD",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "57625",
            "telephone_number": "505-860-8927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAZZIE",
        "first_name": "THERESA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NM",
            "license": "L1741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Coleen Widow
• Jauron Brandt Widow
• Stephen Andrew Williams, RN
• Angel Lee Wilson-Crowe, ARNP
• Amanda Wortman, FNP
• Kathleeen Kae Zambo, CNP
• Judy Zhang, PHARMD, RPH

• Licensed Practical Nurse in Eagle Butte, SD
• Providers in Eagle Butte, SD by specialty
• Licensed Practical Nurse in South Dakota

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