Provider Demographics
NPI:1265123103
Name:FIELDS, YVETTER A (CNA)
Entity type:Individual
Prefix:MS
First Name:YVETTER
Middle Name:A
Last Name:FIELDS
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:PO BOX 10552
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34603-0552
Mailing Address - Country:US
Mailing Address - Phone:352-403-6350
Mailing Address - Fax:
Practice Address - Street 1:965 CANDLELIGHT BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-3100
Practice Address - Country:US
Practice Address - Phone:352-403-6350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-19
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide