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General NPI Number Information
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NPI Number | 1609658806
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Entity Type | Individual
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Provider Name | YOLANDA FAYE VINES RN
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Gender | Female
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Dates
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Enumeration Date | 10/20/2023
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 15064 CARROLLTON BLVD STE 23
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City | CARROLLTON
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State | VA
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Zip | 23314-3582
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Country | US
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Telephone | 757-761-4030
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Fax | 757-884-3005
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Provider Business Mailing Address
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Address Line | 15064 CARROLLTON BLVD STE 23
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City | CARROLLTON
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State | VA
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Zip | 23314-3582
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Country | US
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Telephone | 757-761-4030
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Fax | 757-884-3005
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 0001255746
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 0001255746
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License Number State | VA
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