Provider Demographics
NPI:1114405636
Name:YONGA, MICHELE-VERA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE-VERA
Middle Name:
Last Name:YONGA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7452 BALTIMORE ANNAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-3547
Mailing Address - Country:US
Mailing Address - Phone:443-374-5044
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DR # B2L124
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-3547
Practice Address - Country:US
Practice Address - Phone:301-273-4169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR205616363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily