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General NPI Number Information
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NPI Number | 1023460110
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Entity Type | Individual
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Provider Name | CHRISTY CHANG APNP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 430 E DIVISION ST
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City | FOND DU LAC
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State | WI
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Zip | 54935-4597
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Country | US
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Telephone | 920-926-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 N 7TH ST
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City | SHEBOYGAN
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State | WI
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Zip | 53081-2720
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Country | US
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Telephone | 920-980-1349
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 32088931
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 15421
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1542133
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License Number State | WI
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