=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669443834
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YANICK DANTISTE RANKINE ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7305 N MILITARY TRL
-----------------------------------------------------
City | RIVIERA BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33410-7417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-422-8262
-----------------------------------------------------
Fax | 561-422-8360
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15170 99TH N
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33412-0000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-204-1666
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | ARNP2180102
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------