Provider Demographics
NPI:1225354418
Name:LEDAIN, YOLANDA L (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:L
Last Name:LEDAIN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:L
Other - Last Name:LEDAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:1108 NEW POINTE BLVD STE 130 PMB1080
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-1279
Mailing Address - Country:US
Mailing Address - Phone:845-538-9668
Mailing Address - Fax:
Practice Address - Street 1:1108 NEW POINTE BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-1279
Practice Address - Country:US
Practice Address - Phone:845-538-9668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-13
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297288-1164W00000X
NC5019874363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse