Provider Demographics
NPI:1568472637
Name:ZENG-WANG, YIPING MAGGIE (FNP)
Entity Type:Individual
Prefix:
First Name:YIPING
Middle Name:MAGGIE
Last Name:ZENG-WANG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17900 23 MILE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-1161
Mailing Address - Country:US
Mailing Address - Phone:313-745-4405
Mailing Address - Fax:313-966-0665
Practice Address - Street 1:3901 BEAUBIEN - 4TH FL CARL'S BLDG
Practice Address - Street 2:CHILDREN'S HOSPITAL OF MI
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-4485
Practice Address - Fax:313-745-5155
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704211485363LP0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP00231995OtherRR MEDICARE
MIYZ211485OtherBLUE SHIELD
MI470245010Medicaid
MI470451610Medicaid
MI470245010Medicaid
MI470245010Medicaid
MIP11300003Medicare ID - Type Unspecified