MEDICARE: NICOLE YOUNGBLOOD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1275480972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NICOLE YOUNGBLOOD INC

Provider Business Mailing Address
First Line	:	1305 NE 13TH ST
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32601-4654
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1305 NE 13TH ST
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32601-4654
Country	:	US
Telephone Number	:	352-358-1060
Fax Number	:	888-660-1060

Authorized Official
Title or Position	:	OWNER
Name	:	NICOLE CLEMONS
Credential	:
Telephone Number	:	352-278-2126

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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Directions to “NICOLE YOUNGBLOOD INC ” Practice Location

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