| Torianne Miranda Yetter, PA | |
|
49 Rock Springs Rd, Conowingo, MD 21918-1352 | |
| (410) 378-9696 | |
| (410) 378-9922 |
| Full Name | Torianne Miranda Yetter |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 49 Rock Springs Rd, Conowingo, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760851299 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | C5-0001107 (Delaware) | Secondary |
| 363A00000X | Physician Assistant | C06810 (Maryland) | Primary |
| Entity Name | Christiana Care Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245474329 PECOS PAC ID: 9739097569 Enrollment ID: O20091027000729 |
| Entity Name | Apogee Medical Group Delaware Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326485285 PECOS PAC ID: 9638312572 Enrollment ID: O20130826000448 |
| Entity Name | Diamond State Primary Care, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386246940 PECOS PAC ID: 3870904931 Enrollment ID: O20201120000163 |
| Mailing Address | Practice Location Address |
|---|---|
| Torianne Miranda Yetter, PA Po Box 99, Conowingo, MD 21918-0099 Ph: (410) 378-9696 | Torianne Miranda Yetter, PA 49 Rock Springs Rd, Conowingo, MD 21918-1352 Ph: (410) 378-9696 |
Susan Ferenz, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 480 E Red Hill Rd, Conowingo, MD 21918 Phone: 443-466-6963 |