Provider Demographics
NPI:1780018143
Name:BONE, YOLANDA (ARNP)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:BONE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 SAINT MICHAEL DR
Mailing Address - Street 2:SUITE 238
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2379
Mailing Address - Country:US
Mailing Address - Phone:903-614-5480
Mailing Address - Fax:903-614-5486
Practice Address - Street 1:2604 SAINT MICHAEL DR
Practice Address - Street 2:SUITE 238
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2379
Practice Address - Country:US
Practice Address - Phone:903-614-5355
Practice Address - Fax:903-614-5399
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128779363L00000X
FL9281670363LF0000X
ARA004178363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR204571758Medicaid