Provider Demographics
NPI:1558919183
Name:WANG, ELIZABETH (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:HUANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:5861 CINEMA DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1489
Mailing Address - Country:US
Mailing Address - Phone:513-248-8800
Mailing Address - Fax:
Practice Address - Street 1:5861 CINEMA DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1489
Practice Address - Country:US
Practice Address - Phone:513-248-8800
Practice Address - Fax:513-248-8177
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28235945A163W00000X
OHCNP.0027483363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2565399Medicaid