Healthcare Provider Details

I. General information

NPI: 1811165145
Provider Name (Legal Business Name): KAREN YENCHO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 WEST RD STE 200
ELLINGTON CT
06029-3730
US

IV. Provider business mailing address

175 WEST RD STE 200
ELLINGTON CT
06029-3730
US

V. Phone/Fax

Practice location:
  • Phone: 860-375-9122
  • Fax: 860-375-9133
Mailing address:
  • Phone: 860-375-9122
  • Fax: 860-375-9133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number002132
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: