Provider Demographics
NPI:1386304921
Name:YUNGK, AMELIA E (APRN)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:E
Last Name:YUNGK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 S QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-1022
Mailing Address - Country:US
Mailing Address - Phone:860-805-1986
Mailing Address - Fax:
Practice Address - Street 1:1057 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2644
Practice Address - Country:US
Practice Address - Phone:203-458-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.009657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily