Provider Demographics
NPI:1619995099
Name:YUKNA, PAMELA D (APRN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:D
Last Name:YUKNA
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 1:56 FRANKLIN ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1221
Mailing Address - Country:US
Mailing Address - Phone:203-709-8873
Mailing Address - Fax:203-709-8689
Practice Address - Street 1:56 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1221
Practice Address - Country:US
Practice Address - Phone:203-709-6000
Practice Address - Fax:203-709-3679
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002953363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT01407877OtherCOVENTRY/FIRST HEALTH
CT0957742OtherUSA
CT400002953CT01OtherANTHEM BCBS CT
CT239322OtherWELLCARE
CTP00456217OtherRR MEDICARE
CT004242939Medicaid
CT20953OtherCONNECTICARE
CTP3249497OtherOXFORD
CT7680674OtherAETNA
CT0957742OtherUSA
CTP3249497OtherOXFORD