Provider Demographics
NPI:1487084174
Name:YELVERTON, LACHRYSTAL I
Entity type:Individual
Prefix:
First Name:LACHRYSTAL
Middle Name:
Last Name:YELVERTON
Suffix:I
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 1:4540 BENNING RD SE APT 101
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5182
Mailing Address - Country:US
Mailing Address - Phone:202-321-2357
Mailing Address - Fax:
Practice Address - Street 1:4540 BENNING RD SE APT 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5182
Practice Address - Country:US
Practice Address - Phone:202-321-2357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide