Healthcare Provider Details

I. General information

NPI: 1538871181
Provider Name (Legal Business Name): YUCHEN NAMKHAI LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 12/14/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 PINEBROOK DR
EASTHAMPTON MA
01027-9719
US

IV. Provider business mailing address

13 PINEBROOK DR
EASTHAMPTON MA
01027-9719
US

V. Phone/Fax

Practice location:
  • Phone: 413-522-7573
  • Fax:
Mailing address:
  • Phone: 413-522-7573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN95057
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: