Provider Demographics
NPI:1124887732
Name:YANGA, KAYLA MARIE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:MARIE
Last Name:YANGA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 PARK AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3500
Mailing Address - Country:US
Mailing Address - Phone:908-450-7002
Mailing Address - Fax:
Practice Address - Street 1:88 PARK AVE STE 1A
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-3500
Practice Address - Country:US
Practice Address - Phone:908-450-7002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15034500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine