Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704282753 | MI |
N | 363L00000X | Nurse Practitioner | APRN.CNP.021840 | OH |
NPI | 1003351495 |
---|---|
Provider Name | Juan Huang |
First Address | Detroit, MI 48202-3450 |
Second Address | West Bloomfield, MI 48322-3013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2016 |
Last Update Date | 19/01/2022 |