MEDICARE: DR. ELIZABETH WANG DNP, 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	163W00000X	Registered Nurse	28235945A	IN
2	363LF0000X	Family Nurse Practitioner	CNP.0027483	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558919183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH WANG DNP, APRN, FNP-BC

Provider Business Mailing Address
First Line	:	5861 CINEMA DR
Second Line	:
City	:	MILFORD
State	:	OH
Zip	:	45150-1489
Country	:	US
Telephone Number	:	513-248-8800
Fax Number	:

Provider Business Practice Location Address
First Line	:	5861 CINEMA DR
Second Line	:
City	:	MILFORD
State	:	OH
Zip	:	45150-1489
Country	:	US
Telephone Number	:	513-248-8800
Fax Number	:	513-248-8177

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

Provider Enumeration Date	:	08/27/2019
Last Update Date	:	08/03/2023

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