Provider Demographics
NPI:1043080971
Name:JEAN-LOUIS MARTELLY, YOLETTE (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:YOLETTE
Middle Name:
Last Name:JEAN-LOUIS MARTELLY
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7009 MAIDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-3347
Mailing Address - Country:US
Mailing Address - Phone:561-633-1829
Mailing Address - Fax:
Practice Address - Street 1:7009 MAIDSTONE DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-3347
Practice Address - Country:US
Practice Address - Phone:561-633-1829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2023036446363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology