Individual
MRS. YVETTE MICHELLE MIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
107 GAYNOR AVE, SYRACUSE, NY 13206-2024
(315) 414-7672
Mailing address
107 GAYNOR AVE, SYRACUSE, NY 13206-2024
(315) 414-7672
Taxonomy
Speciality
Code
Description
License number
State
163WR0400X
Rehabilitation Registered Nurse
421972
NY
163WW0000X
Wound Care Registered Nurse
Primary
421972
NY
163WX0106X
Occupational Health Registered Nurse
421972
NY
Other
Enumeration date
08/30/2013
Last updated
08/30/2013
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