Provider Demographics
NPI:1851581565
Name:YANKOLONIS, AMY RENEA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:RENEA
Last Name:YANKOLONIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:RENEA
Other - Last Name:KINCAID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:4111 LOWER BECKLEYSVILLE RD STE C
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-2248
Mailing Address - Country:US
Mailing Address - Phone:410-374-0808
Mailing Address - Fax:
Practice Address - Street 1:4111 LOWER BECKLEYSVILLE RD STE C
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-2248
Practice Address - Country:US
Practice Address - Phone:410-374-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-29
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR167589363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily