Provider Demographics
NPI:1215350913
Name:LIU, YIYANG EMILY (FNP-C)
Entity type:Individual
Prefix:
First Name:YIYANG
Middle Name:EMILY
Last Name:LIU
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10237 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-1804
Mailing Address - Country:US
Mailing Address - Phone:512-965-3578
Mailing Address - Fax:
Practice Address - Street 1:2306 RENT RD 620 S
Practice Address - Street 2:MINUTECLINIC
Practice Address - City:LAKE WAY
Practice Address - State:TX
Practice Address - Zip Code:78734
Practice Address - Country:US
Practice Address - Phone:512-965-3578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338480363LF0000X
TXAP127972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily