Provider Demographics
NPI:1023729167
Name:DORNER, YVETTE ANNA (CARE PROVIDER)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:ANNA
Last Name:DORNER
Suffix:
Gender:F
Credentials:CARE PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 N OHENRY BLVD APT A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-4662
Mailing Address - Country:US
Mailing Address - Phone:336-897-4296
Mailing Address - Fax:
Practice Address - Street 1:2815 N OHENRY BLVD APT A
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4662
Practice Address - Country:US
Practice Address - Phone:336-897-4296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32231692374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide