Basic Information
| Provider Information | |||||||||
| NPI: | 1073093258 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YAEMSANG | ||||||||
| FirstName: | RACHANEE | ||||||||
| MiddleName: | RENEE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CNM, ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19730 ELLENDALE DR | ||||||||
| Address2: | |||||||||
| City: | LAND O LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346388011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8133806546 | ||||||||
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| Practice Location | |||||||||
| Address1: | 880 NW 13TH ST STE 330 | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334862342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614132832 | ||||||||
| FaxNumber: | 5614392505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2018 | ||||||||
| LastUpdateDate: | 09/21/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | ARNP9398449 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.