Provider Demographics
NPI:1861239287
Name:ARGUETA, YELENNY AMAIRANY
Entity type:Individual
Prefix:
First Name:YELENNY
Middle Name:AMAIRANY
Last Name:ARGUETA
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 1:2765 MILTON BRYAN DR
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-3903
Mailing Address - Country:US
Mailing Address - Phone:678-650-7959
Mailing Address - Fax:
Practice Address - Street 1:2765 MILTON BRYAN DR
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-3903
Practice Address - Country:US
Practice Address - Phone:678-650-7959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN287709207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine