Provider Demographics
NPI:1770464869
Name:YASSIN, MEDINA H
Entity type:Individual
Prefix:
First Name:MEDINA
Middle Name:H
Last Name:YASSIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 S HAVANA ST STE 609
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-1075
Mailing Address - Country:US
Mailing Address - Phone:720-496-8692
Mailing Address - Fax:
Practice Address - Street 1:60 S HAVANA ST STE 609
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-1075
Practice Address - Country:US
Practice Address - Phone:720-496-8692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04QVFS253Z00000X
CO046F81376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No253Z00000XAgenciesIn Home Supportive Care