Provider Demographics
NPI:1205486925
Name:RABB, YOLANDA NICOLE (CNA)
Entity type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:NICOLE
Last Name:RABB
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6786 BENT CREEK DR
Mailing Address - Street 2:
Mailing Address - City:REX
Mailing Address - State:GA
Mailing Address - Zip Code:30273-2100
Mailing Address - Country:US
Mailing Address - Phone:678-431-9230
Mailing Address - Fax:
Practice Address - Street 1:6786 BENT CREEK DR
Practice Address - Street 2:
Practice Address - City:REX
Practice Address - State:GA
Practice Address - Zip Code:30273-2100
Practice Address - Country:US
Practice Address - Phone:678-431-9230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-14
Last Update Date:2019-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030049124374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty