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General NPI Number Information
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NPI Number | 1427664564
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Entity Type | Individual
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Provider Name | YELENA POCITOVII FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/22/2020
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 400 VISTA LAKE DR APT 104
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City | CANDLER
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State | NC
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Zip | 28715-7174
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Country | US
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Telephone | 678-221-1880
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Fax |
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Provider Business Mailing Address
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Address Line | 100 VISTA LAKE DR APT 208
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City | CANDLER
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State | NC
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Zip | 28715-5104
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Country | US
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Telephone | 678-221-1880
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5014737
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License Number State | NC
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