Provider Demographics
NPI:1053398883
Name:CLARKE, YVONNE JOAN (ARNP)
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:JOAN
Last Name:CLARKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13201 PARKHURST CT
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5756
Mailing Address - Country:US
Mailing Address - Phone:813-654-8062
Mailing Address - Fax:813-741-3290
Practice Address - Street 1:10420 US HIGHWAY 301 S
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-5806
Practice Address - Country:US
Practice Address - Phone:813-741-0019
Practice Address - Fax:813-741-3290
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3184902363LF0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303297300Medicaid
VAD-000Medicare UPIN
FL303297300Medicaid