Individual
MARY YATES CODRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
9729 FARAWAY FARM RD, TALLAHASSEE, FL 32317-1603
(850) 294-4978
Mailing address
9729 FARAWAY FARM RD, TALLAHASSEE, FL 32317-1603
(850) 294-4978
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11023498
FL
Other
Enumeration date
03/31/2023
Last updated
03/31/2023
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