Provider Demographics
NPI:1770940827
Name:ENAKHIMION, YAHAYA EHIGIE (MSN, CRNP, FNP-C)
Entity type:Individual
Prefix:MR
First Name:YAHAYA
Middle Name:EHIGIE
Last Name:ENAKHIMION
Suffix:
Gender:M
Credentials:MSN, CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 MEMORIAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-1714
Mailing Address - Country:US
Mailing Address - Phone:215-287-7260
Mailing Address - Fax:
Practice Address - Street 1:2600 SOUTHAMPTON RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-1527
Practice Address - Country:US
Practice Address - Phone:215-287-7260
Practice Address - Fax:215-550-5101
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0011628363LF0000X
PASP015846363LP2300X, 364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care