Provider Demographics
NPI:1649812678
Name:MEDELEZ, YVONNE URESTI (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:URESTI
Last Name:MEDELEZ
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 VILLA DEL NORTE
Mailing Address - Street 2:
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-5663
Mailing Address - Country:US
Mailing Address - Phone:956-648-9672
Mailing Address - Fax:
Practice Address - Street 1:230 N 86TH ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-0012
Practice Address - Country:US
Practice Address - Phone:956-296-1711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-10
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143353363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4078479-03Medicaid