Provider Demographics
NPI:1568956720
Name:ZETAR, YOLANDA MONIQUE
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:MONIQUE
Last Name:ZETAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8947 HIGHLAND DAWN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-4408
Mailing Address - Country:US
Mailing Address - Phone:404-791-0700
Mailing Address - Fax:
Practice Address - Street 1:7330 SAN PEDRO AVE STE 800
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6268
Practice Address - Country:US
Practice Address - Phone:210-733-0524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX232007164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse