MEDICARE: QIYE WENDY LI APRN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN283060	MA

General Provider Information

NPI Number	:	1457820623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QIYE WENDY LI APRN, FNP-BC

Provider Business Mailing Address
First Line	:	65 WALNUT ST STE 330
Second Line	:
City	:	WELLESLEY
State	:	MA
Zip	:	02481-2154
Country	:	US
Telephone Number	:	617-630-0380
Fax Number	:	617-630-2026

Provider Business Practice Location Address
First Line	:	65 WALNUT ST STE 330
Second Line	:
City	:	WELLESLEY
State	:	MA
Zip	:	02481-2154
Country	:	US
Telephone Number	:	617-630-0380
Fax Number	:	617-630-2026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2018
Last Update Date	:	01/04/2024

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