Provider Demographics
NPI:1801354410
Name:CHENOWETH, YOLANDA (APRN FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:
Last Name:CHENOWETH
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 N MAIN ST STE 209
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:IL
Mailing Address - Zip Code:60548-1396
Mailing Address - Country:US
Mailing Address - Phone:815-786-1967
Mailing Address - Fax:
Practice Address - Street 1:1310 N MAIN ST STE 209
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:IL
Practice Address - Zip Code:60548-1396
Practice Address - Country:US
Practice Address - Phone:815-786-1967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209018850363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily