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General NPI Number Information
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NPI Number | 1467263152
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Entity Type | Individual
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Provider Name | IVANNA YAU NP
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Gender | Female
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 7001 ORCHARD RD STE 320C
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City | WEST BLOOMFIELDS
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State | MI
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Zip | 48322
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Country | US
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Telephone | 248-483-0345
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Fax |
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Provider Business Mailing Address
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Address Line | 1591 OXFORD RD
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City | BERKLEY
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State | MI
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Zip | 48072-2029
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704381402
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704381402
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License Number State | MI
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