Provider Demographics
NPI:1083859789
Name:BLAISE, YANA NICOLE (RN, FNP)
Entity Type:Individual
Prefix:
First Name:YANA
Middle Name:NICOLE
Last Name:BLAISE
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:COCONUT GROVE
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4953
Mailing Address - Country:US
Mailing Address - Phone:305-446-5917
Mailing Address - Fax:305-446-0712
Practice Address - Street 1:486 FISHERMAN ST
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-3818
Practice Address - Country:US
Practice Address - Phone:305-688-5456
Practice Address - Fax:305-688-1661
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000162414363LF0000X
FLARNP9278753363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily