Provider Demographics
NPI:1720548415
Name:HANG, SHOUA DOROTHY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHOUA
Middle Name:DOROTHY
Last Name:HANG
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9379 S 35TH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-9151
Mailing Address - Country:US
Mailing Address - Phone:414-699-4219
Mailing Address - Fax:
Practice Address - Street 1:9379 S 35TH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-9151
Practice Address - Country:US
Practice Address - Phone:414-699-4219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9119-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily