MEDICARE: YVETTE JEAN FLETCHER-PRINCE APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	HSE32374	FL
2	363L00000X	Nurse Practitioner	APRN2517192	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235133786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVETTE JEAN FLETCHER-PRINCE APRN

Provider Business Mailing Address
First Line	:	2331 N STATE ROAD 7 STE 102
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33313-3771
Country	:	US
Telephone Number	:	954-589-1238
Fax Number	:

Provider Business Practice Location Address
First Line	:	2331 N STATE ROAD 7 STE 102
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33313-3771
Country	:	US
Telephone Number	:	954-484-8444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	03/27/2024

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Directions to “ YVETTE JEAN FLETCHER-PRINCE APRN” Practice Location

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