Provider Demographics
NPI:1457851552
Name:HERRINGTON, YVETTE M (APRN)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:M
Last Name:HERRINGTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-432-8500
Mailing Address - Fax:
Practice Address - Street 1:4051 UPPER CREEK DR STE 103B
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-6848
Practice Address - Country:US
Practice Address - Phone:813-633-3955
Practice Address - Fax:813-633-0441
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2749682363LF0000X, 363L00000X
FLARNP2749682207RH0003X
NHEL10865363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102292300Medicaid
FL102292300Medicaid
FLAPRN2749682OtherMEDICAL LICENSE