Provider Demographics
NPI:1518107564
Name:YEATES, JANEE GWENETTE (PHARM D)
Entity Type:Individual
Prefix:
First Name:JANEE
Middle Name:GWENETTE
Last Name:YEATES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 MISSION RD
Mailing Address - Street 2:APT 1603
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-2638
Mailing Address - Country:US
Mailing Address - Phone:850-504-1466
Mailing Address - Fax:
Practice Address - Street 1:1401 CENTERVILLE RD
Practice Address - Street 2:SUITE 504
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4647
Practice Address - Country:US
Practice Address - Phone:850-431-7019
Practice Address - Fax:850-431-6101
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 44521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist