Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN-197 | HI |
NPI | 1023088937 |
---|---|
Provider Name | Dr. Chen Yen Grace Wang |
First Address | Honolulu, HI 96817-4544 |
Second Address | Honolulu, HI 96817-4544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 15/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
52519901 | (05) | HI |
P67543 | (02) | HI |