Provider Demographics
NPI:1669826434
Name:CARTER, YOLANDA SABRINA
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:SABRINA
Last Name:CARTER
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 1:552382 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:FL
Mailing Address - Zip Code:32046-2328
Mailing Address - Country:US
Mailing Address - Phone:904-675-9230
Mailing Address - Fax:904-675-9231
Practice Address - Street 1:552382 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:FL
Practice Address - Zip Code:32046-2328
Practice Address - Country:US
Practice Address - Phone:904-675-9230
Practice Address - Fax:904-675-9231
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372500000X, 374U00000X, 376J00000X, 376K00000X, 372600000X, 372600000X
FL234380374T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100315800Medicaid