Provider Demographics
NPI:1770238701
Name:SCHULTHEISS, VIVIAN YANG (FNP-BC)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:YANG
Last Name:SCHULTHEISS
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 1:244 PARK ST APT B27
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-1258
Mailing Address - Country:US
Mailing Address - Phone:781-812-7243
Mailing Address - Fax:
Practice Address - Street 1:202 W NC HIGHWAY 54 STE 502
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7565
Practice Address - Country:US
Practice Address - Phone:919-885-1716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC339915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily