Provider Demographics
NPI:1740440403
Name:ROBERTSON, YLANNA (LPN)
Entity type:Individual
Prefix:
First Name:YLANNA
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9502 KINGS HWY
Mailing Address - Street 2:416
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-2760
Mailing Address - Country:US
Mailing Address - Phone:347-406-9709
Mailing Address - Fax:
Practice Address - Street 1:279 E 3RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-7813
Practice Address - Country:US
Practice Address - Phone:212-477-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293334164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse