Provider Demographics
NPI:1316438328
Name:YANG, KE (NP)
Entity type:Individual
Prefix:
First Name:KE
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 FRONT PORCH WAY
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-7064
Mailing Address - Country:US
Mailing Address - Phone:816-651-5406
Mailing Address - Fax:
Practice Address - Street 1:7510 RAMBLE WAY STE 107
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-4305
Practice Address - Country:US
Practice Address - Phone:919-747-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011060363LF0000X
MO2018005739363LF0000X
KS78065363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily