Healthcare Provider Details

I. General information

NPI: 1992956734
Provider Name (Legal Business Name): LING JUI LING CHANG CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUI-LING YANG CRNA

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 CAREW STREET
SPRINGFIELD MA
01102
US

IV. Provider business mailing address

1613 N HARRISON PARKWAY SUITE 200 MAILSTOP SH-9A
SUNRISE FL
33323-2896
US

V. Phone/Fax

Practice location:
  • Phone: 413-748-9000
  • Fax: 352-237-9808
Mailing address:
  • Phone: 954-838-2371
  • Fax: 954-616-3866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9274709
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2275887
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: