Provider Demographics
NPI:1518516210
Name:ZHANG, CUICUI (APRN)
Entity Type:Individual
Prefix:
First Name:CUICUI
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8686 S 1300 E # L102L104
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-1947
Mailing Address - Country:US
Mailing Address - Phone:801-997-0368
Mailing Address - Fax:
Practice Address - Street 1:8686 S 1300 E # L102L104
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-1947
Practice Address - Country:US
Practice Address - Phone:801-997-0368
Practice Address - Fax:801-382-7898
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7716092-4405207QA0401X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT3014893Medicaid