Provider Demographics
NPI:1255883021
Name:YENGO, PATIENCE YOUNE (FNP)
Entity type:Individual
Prefix:
First Name:PATIENCE
Middle Name:YOUNE
Last Name:YENGO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9810 LAKEPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1822
Mailing Address - Country:US
Mailing Address - Phone:703-309-9369
Mailing Address - Fax:
Practice Address - Street 1:9810 LAKEPOINTE DR
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1822
Practice Address - Country:US
Practice Address - Phone:703-309-9369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174116363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024174116OtherFNP LICENSE NUMBER