Provider Demographics
NPI:1811223753
Name:MCCORD, YOLONDA ANN (AAPRN)
Entity Type:Individual
Prefix:
First Name:YOLONDA
Middle Name:ANN
Last Name:MCCORD
Suffix:
Gender:F
Credentials:AAPRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 EVENING SHADE LN
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33974-0809
Mailing Address - Country:US
Mailing Address - Phone:614-668-9040
Mailing Address - Fax:
Practice Address - Street 1:9235 RIDGELINE DR
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-9459
Practice Address - Country:US
Practice Address - Phone:614-668-9040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021730363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2998814Medicaid