Healthcare Provider Details

I. General information

NPI: 1194202432
Provider Name (Legal Business Name): YELENA ABITOL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4210 OLD CHARLOTTE HWY
MONROE NC
28110-7333
US

IV. Provider business mailing address

4210 OLD CHARLOTTE HWY
MONROE NC
28110-7333
US

V. Phone/Fax

Practice location:
  • Phone: 704-291-3393
  • Fax:
Mailing address:
  • Phone: 704-291-3393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number9375127
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5013855
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: