Basic Information
| Provider Information | |||||||||
| NPI: | 1962847194 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YONKIN | ||||||||
| FirstName: | INGRID | ||||||||
| MiddleName: | JOHANNA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | HANSEN | ||||||||
| OtherFirstName: | INGRID | ||||||||
| OtherMiddleName: | JOHANNA | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4155 GUADALCANAL CIR APT A | ||||||||
| Address2: | |||||||||
| City: | KAPOLEI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967073555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188362407 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | TRIPLER ARMY COMMUNITY CENTER | ||||||||
| Address2: | 1 JARRETT WHITE RD | ||||||||
| City: | TRIPLER AMC | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968595001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084332460 | ||||||||
| FaxNumber: | 8084331558 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2013 | ||||||||
| LastUpdateDate: | 02/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 4301104474 | MI | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.