Provider Demographics
NPI:1568790350
Name:YANCEY, LAURA W (APRN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:W
Last Name:YANCEY
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 1:6804 PORTO FINO CIR STE 1
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-7139
Mailing Address - Country:US
Mailing Address - Phone:239-332-4700
Mailing Address - Fax:888-769-5641
Practice Address - Street 1:6804 PORTO FINO CIR STE 1
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-7139
Practice Address - Country:US
Practice Address - Phone:239-332-4700
Practice Address - Fax:888-769-5641
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14632363LF0000X
FLAPRN0338899363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily