Provider Demographics
NPI:1467075838
Name:DRAINE, YOLANDA S (DHA)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:S
Last Name:DRAINE
Suffix:
Gender:F
Credentials:DHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 UNION AVE # 125
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-3725
Mailing Address - Country:US
Mailing Address - Phone:901-451-4440
Mailing Address - Fax:
Practice Address - Street 1:420 MONROE AVE # 1413
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-3252
Practice Address - Country:US
Practice Address - Phone:901-451-4440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies