MEDICARE: AMY ELIZABETH YENTSCH CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	RN2273321	MA
2	363LA2200X	Adult Health Nurse Practitioner	RN2273321	MA
3	363LG0600X	Gerontology Nurse Practitioner	RN2273321	MA
4	363LP2300X	Primary Care Nurse Practitioner	RN2273321	MA
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN2273321	MA

General Provider Information

NPI Number	:	1922556117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY ELIZABETH YENTSCH CNP

Provider Business Mailing Address
First Line	:	673 BEDFORD ST
Second Line	:
City	:	ABINGTON
State	:	MA
Zip	:	02351-1921
Country	:	US
Telephone Number	:	781-801-5766
Fax Number	:

Provider Business Practice Location Address
First Line	:	673 BEDFORD ST
Second Line	:
City	:	ABINGTON
State	:	MA
Zip	:	02351-1921
Country	:	US
Telephone Number	:	781-269-9767
Fax Number	:	781-421-3224

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2016
Last Update Date	:	06/10/2021

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