Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | NP22274 | CA |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 22274 | CA |
NPI | 1033460258 |
---|---|
Provider Name | Wen Fang Yuan |
First Address | Fresno, CA 93727-1560 |
Second Address | Fresno, CA 93701-2230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2012 |
Last Update Date | 02/11/2012 |