Provider Demographics
NPI:1538871181
Name:NAMKHAI, YUCHEN (LPN)
Entity type:Individual
Prefix:
First Name:YUCHEN
Middle Name:
Last Name:NAMKHAI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 PINEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-9719
Mailing Address - Country:US
Mailing Address - Phone:413-522-7573
Mailing Address - Fax:
Practice Address - Street 1:13 PINEBROOK DR
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-9719
Practice Address - Country:US
Practice Address - Phone:413-522-7573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
314000000X
MALPN95057164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility