Healthcare Provider Details

I. General information

NPI: 1073548731
Provider Name (Legal Business Name): YOLANDA Y GONZALEZ RNC NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YOLANDA Y ZEPEDA

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 MEZZANINE DR SUITE C
LAFAYETTE IN
47905-8635
US

IV. Provider business mailing address

PO BOX 637764
CINCINNATI OH
45263-7764
US

V. Phone/Fax

Practice location:
  • Phone: 765-807-2780
  • Fax: 765-807-2781
Mailing address:
  • Phone: 317-880-3939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71001963A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number71001963A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: