Provider Demographics
NPI:1699277913
Name:YANCEY, VIVECA DANNETTE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:VIVECA
Middle Name:DANNETTE
Last Name:YANCEY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 FORT CAROLINE RD STE 20-1011
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32277-1807
Mailing Address - Country:US
Mailing Address - Phone:904-478-9604
Mailing Address - Fax:904-295-0660
Practice Address - Street 1:6035 FORT CAROLINE RD STE 20-1011
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277-1807
Practice Address - Country:US
Practice Address - Phone:904-478-9604
Practice Address - Fax:904-295-0660
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9239828363LF0000X
FLAPRN9239828363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily