Provider Demographics
NPI:1043442916
Name:YORKE, MINDY B (ARNP (FNP-BC))
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:B
Last Name:YORKE
Suffix:
Gender:F
Credentials:ARNP (FNP-BC)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2073 WOODFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-6647
Mailing Address - Country:US
Mailing Address - Phone:321-727-1301
Mailing Address - Fax:
Practice Address - Street 1:65 E NASA BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1961
Practice Address - Country:US
Practice Address - Phone:321-727-1301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1726902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily