Provider Demographics
NPI:1124136668
Name:ROBERTSON-HACKNEY, YOLANDE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:YOLANDE
Middle Name:MARIE
Last Name:ROBERTSON-HACKNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YOLANDE
Other - Middle Name:MARIE
Other - Last Name:HACKNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1111 SPRING ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4003
Mailing Address - Country:US
Mailing Address - Phone:301-585-0040
Mailing Address - Fax:301-565-8079
Practice Address - Street 1:1111 SPRING ST
Practice Address - Street 2:SUITE 220
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4003
Practice Address - Country:US
Practice Address - Phone:301-585-0040
Practice Address - Fax:301-565-8079
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0048033207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0703588OtherUHC COMM
MD08162OtherAMERIGROUP
MD502040OtherNCPPO
MD2995447OtherAETNA HMO
MD534925-03OtherBC/BSMD
MD100863OtherPIORITY PARTNERS
MD5267046OtherAETNA PPO
DC0002OtherBC/BSMD
MD633194OtherMAMSI
MD363281401Medicaid
MD633194OtherMAMSI