Healthcare Provider Details

I. General information

NPI: 1104278258
Provider Name (Legal Business Name): MRS. KATELYN ENWRIGHT YANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATELYN ENWRIGHT NP

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 08/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LAHEY HOSPITAL AND MEDICAL CENTER 41 MALL ROAD
BURLINGTON MA
01805
US

IV. Provider business mailing address

LAHEY HOSPITAL AND MEDICAL CENTER 41 MALL ROAD
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-8460
  • Fax: 781-744-5261
Mailing address:
  • Phone: 781-744-8460
  • Fax: 781-744-5261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2268882
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: