Provider Demographics
NPI:1669930640
Name:YANG, BROOKE SHIHUI (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:SHIHUI
Last Name:YANG
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:SHIHUI
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SHIHUI YANG
Mailing Address - Street 1:7060 BELLTOLL CT
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2510
Mailing Address - Country:US
Mailing Address - Phone:404-279-2260
Mailing Address - Fax:
Practice Address - Street 1:7060 BELLTOLL CT
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-2510
Practice Address - Country:US
Practice Address - Phone:404-279-2260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN237645363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE