Healthcare Provider Details

I. General information

NPI: 1265638290
Provider Name (Legal Business Name): JANN G YANKEE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 NC 54 SUITE 240, 360
DURHAM NC
27113
US

IV. Provider business mailing address

149 SUNNY ACRES RD
RALEIGH NC
27603-5382
US

V. Phone/Fax

Practice location:
  • Phone: 919-378-1340
  • Fax:
Mailing address:
  • Phone: 720-201-4826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number3823
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: