Healthcare Provider Details

I. General information

NPI: 1386588028
Provider Name (Legal Business Name): EMILY KATE YIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 RANDOLPH RD STE 512
CHARLOTTE NC
28207-2027
US

IV. Provider business mailing address

3801 LIPTON LN
MINT HILL NC
28227-8852
US

V. Phone/Fax

Practice location:
  • Phone: 704-333-4104
  • Fax:
Mailing address:
  • Phone: 704-502-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberYIN-YSGT7
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: