Doctor Name: | YOLANDA BLEASDALE |
NPI Number: | 1295154235 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 33951 |
Business Practice Address: | 110 Boyce Street Manning, SC - 29102 |
Business Phone Number: | 8034354355 |
Business Fax Number: | |
Mailing Address: | 1938 Bloomville Rd, MANNING |
State: | SC |
Postal Code: | 291025905 |
Phone Number: | 8034738072 |
Fax Number: | |
NPI Enumeration Date: | 04/07/2014 |
NPI Last Update Date: | 04/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WH0200X |
License Number: | 33951 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Home Health |
Taxonomy Definition: |