Provider Demographics
NPI:1508371618
Name:MALY, YANA (FNP-C)
Entity Type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:MALY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 ARGERIAN DR STE 103
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-4140
Mailing Address - Country:US
Mailing Address - Phone:813-991-4991
Mailing Address - Fax:813-907-8942
Practice Address - Street 1:5801 ARGERIAN DR STE 103
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4140
Practice Address - Country:US
Practice Address - Phone:813-991-4991
Practice Address - Fax:813-907-8942
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9349340363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily