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General NPI Number Information
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NPI Number | 1275480972
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Entity Type | Organization
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Legal Business Name | NICOLE YOUNGBLOOD INC
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 1305 NE 13TH ST
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City | GAINESVILLE
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State | FL
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Zip | 32601-4654
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Country | US
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Telephone | 352-358-1060
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Fax | 888-660-1060
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Provider Business Mailing Address
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Address Line | 1305 NE 13TH ST
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City | GAINESVILLE
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State | FL
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Zip | 32601-4654
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE CLEMONS
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Credential |
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Telephone | 352-278-2126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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