Provider Demographics
NPI:1952349342
Name:HITKO, YOLANDA KAYE (FNP, MSN)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:KAYE
Last Name:HITKO
Suffix:
Gender:F
Credentials:FNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3394 E JOLLY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-8594
Mailing Address - Country:US
Mailing Address - Phone:517-272-9700
Mailing Address - Fax:517-272-9706
Practice Address - Street 1:3394 E JOLLY RD
Practice Address - Street 2:SUITE C
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-8594
Practice Address - Country:US
Practice Address - Phone:517-272-9700
Practice Address - Fax:517-272-9706
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704-075780363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA83-00069OtherPHYSICIANS HEALTH PLAN
MI200000002115OtherPHP FAMILY CARE
MI0N72470Medicare ID - Type Unspecified
MI200000002115OtherPHP FAMILY CARE