Provider Demographics
NPI:1710551072
Name:YATES, MELISSA JANE
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JANE
Last Name:YATES
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 1:2257 MARTINS RUN
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-5179
Mailing Address - Country:US
Mailing Address - Phone:407-680-2580
Mailing Address - Fax:
Practice Address - Street 1:2257 MARTINS RUN
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-5179
Practice Address - Country:US
Practice Address - Phone:407-680-2580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula