Provider Demographics
NPI:1659830370
Name:GARRETT, YVETTE MONIQUE
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:MONIQUE
Last Name:GARRETT
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 1:1443 BISCAYNE BAY DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-8665
Mailing Address - Country:US
Mailing Address - Phone:512-430-8359
Mailing Address - Fax:
Practice Address - Street 1:1443 BISCAYNE BAY DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-8665
Practice Address - Country:US
Practice Address - Phone:512-430-8359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL356791376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide