Individual provider Active NPI

Kayla Yancho, FNP-BC

  • Family Nurse Practitioner
  • Warren, MI
National Provider Identifier
1649066978
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704353273 Issued in MI
Practice address
11700 E 10 Mile Rd
Warren, MI 48089-3903
Phone
(810) 620-3163
Fax
(810) 202-7455
NPI assigned
Apr 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704353273 MI Primary

Addresses

Primary practice location

11700 E 10 Mile Rd
Warren, MI 48089-3903

Mailing address

11700 E 10 Mile Rd
Warren, MI 48089-3903
Phone (810) 874-3305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260212004313 MI Practitioner - Nurse Practitioner 4486134152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5422 Deland Rd
Flushing, MI 48433-2902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704353273MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Longevity Clinical LTC Associates of Michigan PLLC CurrentSince Feb 23, 2026 Accepting new patients

Locations

11770 US Highway 1
Ste 102E
Palm Beach Gardens, FL 33408
Phone 56181524270

8045 E Jefferson Ave
Detroit, MI 48214
Phone (313) 821-3525

517 W Page St
Rose City, MI 48654
Phone (989) 685-2442

11700 E 10 Mile Rd
Warren, MI 48089
Phone (586) 353-3800

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1649066978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 E 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480893903",
            "telephone_number": "810-874-3305",
            "fax_number": "810-202-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 E 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480893903",
            "telephone_number": "810-620-3163",
            "fax_number": "810-202-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANCHO",
        "first_name": "KAYLA",
        "name_prefix": "Miss",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-15",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704353273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.