Provider Demographics
NPI:1750461042
Name:VANG, KAYING (MIDWAYHOMEHEALTHCARE)
Entity type:Individual
Prefix:MRS
First Name:KAYING
Middle Name:
Last Name:VANG
Suffix:
Gender:F
Credentials:MIDWAYHOMEHEALTHCARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 PAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55130-3434
Mailing Address - Country:US
Mailing Address - Phone:651-793-6901
Mailing Address - Fax:651-776-5251
Practice Address - Street 1:1324 PAYNE AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-3434
Practice Address - Country:US
Practice Address - Phone:651-793-6901
Practice Address - Fax:651-776-5251
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN931420200175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN931420200Medicaid