Provider Demographics
NPI:1679795785
Name:FIELDS, YVETTE ELIZABETH (PA)
Entity type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:ELIZABETH
Last Name:FIELDS
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:858-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:6100 PAN AMERICAN FREEWAY NE
Practice Address - Street 2:SUITE 330
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3427
Practice Address - Country:US
Practice Address - Phone:505-856-2735
Practice Address - Fax:505-856-2749
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM97PA07363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM10036688OtherCIGNA
NM7671173OtherAETNA
NMP3701Medicaid
NM202027598OtherPRESBYTERIAN
NCNM00RG98OtherBCBS OF NM
NVNM300099OtherMEDICARE PTAN
NMQMP000003410190OtherMOLINA
NM97PA07OtherSTATE LICENSE
NMP3701Medicaid