Provider Demographics
NPI:1518941848
Name:YANCI, TAMMY (MSNNP)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:
Last Name:YANCI
Suffix:
Gender:F
Credentials:MSNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 JACK MARTIN BLVD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-7733
Mailing Address - Country:US
Mailing Address - Phone:732-840-4300
Mailing Address - Fax:732-840-4515
Practice Address - Street 1:446 JACK MARTIN BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7733
Practice Address - Country:US
Practice Address - Phone:732-840-4300
Practice Address - Fax:732-840-4515
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00001800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0061689Medicaid
NJP67808Medicare UPIN
NJ062332P15Medicare ID - Type Unspecified