Provider Demographics
NPI:1154475689
Name:WANG, ELIZABETH C (NP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:C
Last Name:WANG
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:3928 WASHINGTON RD STE 230
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2594
Mailing Address - Country:US
Mailing Address - Phone:724-941-1866
Mailing Address - Fax:724-941-6751
Practice Address - Street 1:3928 WASHINGTON RD STE 230
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2594
Practice Address - Country:US
Practice Address - Phone:724-941-1966
Practice Address - Fax:724-941-6751
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAUP005896G363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAUP005896GOtherLICENSE NUMBER