Provider Demographics
NPI:1801482385
Name:YAHNKE, MEGAN LEA
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LEA
Last Name:YAHNKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 VIRGINIA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26847-1719
Mailing Address - Country:US
Mailing Address - Phone:304-250-4545
Mailing Address - Fax:
Practice Address - Street 1:26 ENGLISH WALNUT LN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:WV
Practice Address - Zip Code:26763-5202
Practice Address - Country:US
Practice Address - Phone:304-257-3397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant