Healthcare Provider Details

I. General information

NPI: 1376489005
Provider Name (Legal Business Name): YUEHCHI JADE WENG FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1491 SOM CENTER RD
MAYFIELD HEIGHTS OH
44124-2101
US

IV. Provider business mailing address

1491 SOM CENTER RD
MAYFIELD HEIGHTS OH
44124-2101
US

V. Phone/Fax

Practice location:
  • Phone: 440-442-1484
  • Fax: 440-684-7827
Mailing address:
  • Phone: 440-442-1484
  • Fax: 440-684-7827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.FNP.0042012
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: