Provider Demographics
NPI:1275533077
Name:MI, ZHANHONG (CNP)
Entity Type:Individual
Prefix:
First Name:ZHANHONG
Middle Name:
Last Name:MI
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 DUDLEY ST
Mailing Address - Street 2:SUITE 470
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3236
Mailing Address - Country:US
Mailing Address - Phone:401-444-5545
Mailing Address - Fax:401-444-6681
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:APC 456
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-444-5545
Practice Address - Fax:401-444-6681
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37178363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIZM49732Medicaid
MA2018381Medicaid
RIZM49732Medicaid
509021627Medicare PIN