Healthcare Provider Details

I. General information

NPI: 1205725389
Provider Name (Legal Business Name): SHU-YI WANG PHD, RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13120 E 19TH AVE RM 4315
AURORA CO
80045-2567
US

IV. Provider business mailing address

13120 E 19TH AVE RM 4315
AURORA CO
80045-2567
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-9125
  • Fax:
Mailing address:
  • Phone: 303-724-9125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.271435
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAPRN.CNS.05085
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.0185614
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: