Provider Demographics
NPI:1386981603
Name:LEVERETT, YULONDA DETRESE (APRN, A-GNP, PMHNP)
Entity type:Individual
Prefix:MRS
First Name:YULONDA
Middle Name:DETRESE
Last Name:LEVERETT
Suffix:
Gender:F
Credentials:APRN, A-GNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 HAGGERTY RD FL USA
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33565-6006
Mailing Address - Country:US
Mailing Address - Phone:863-838-6241
Mailing Address - Fax:
Practice Address - Street 1:14499 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2078
Practice Address - Country:US
Practice Address - Phone:813-530-1414
Practice Address - Fax:813-556-2231
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2960062363LP0808X, 363L00000X
FLARNP2960062363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health