Provider Demographics
NPI:1871387167
Name:NOFER, YANIKZA M
Entity type:Individual
Prefix:
First Name:YANIKZA
Middle Name:M
Last Name:NOFER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3689 SANDHILL CRANE DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-1369
Mailing Address - Country:US
Mailing Address - Phone:717-617-3932
Mailing Address - Fax:
Practice Address - Street 1:3689 SANDHILL CRANE DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33811-1369
Practice Address - Country:US
Practice Address - Phone:717-617-3932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant