Healthcare Provider Details

I. General information

NPI: 1871258442
Provider Name (Legal Business Name): PAULA BIANKA YAKIMCHYK CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 FLORAL VALE BLVD
YARDLEY PA
19067-5528
US

IV. Provider business mailing address

3400 SPRUCE ST
PHILADELPHIA PA
19104-4238
US

V. Phone/Fax

Practice location:
  • Phone: 215-201-1666
  • Fax: 609-964-1904
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP024768
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: