Provider Demographics
NPI:1255730008
Name:YELLE, SHARON (APRN)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:YELLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 GLENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-2376
Mailing Address - Country:US
Mailing Address - Phone:386-804-6121
Mailing Address - Fax:
Practice Address - Street 1:1431 ORANGE CAMP RD STE 115
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-7770
Practice Address - Country:US
Practice Address - Phone:386-202-1401
Practice Address - Fax:386-202-1402
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3386252363LF0000X
FLF0115303363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily