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General NPI Number Information
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NPI Number | 1477946465
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Entity Type | Individual
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Provider Name | SHUJUN CAO FNP
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Gender | Female
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Dates
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Enumeration Date | 03/15/2015
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 824 55TH ST 1FL
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City | BROOKLYN
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State | NY
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Zip | 11220-3263
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Country | US
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Telephone | 718-972-6868
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Fax |
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Provider Business Mailing Address
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Address Line | 50 S B B KING BLVD # 100
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City | MEMPHIS
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State | TN
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Zip | 38103-2626
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Country | US
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Telephone | 901-436-1381
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F339441
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License Number State | NY
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