Provider Demographics
NPI:1396988390
Name:WANG, TING LIN (RN, ACNP, GNP)
Entity type:Individual
Prefix:
First Name:TING
Middle Name:LIN
Last Name:WANG
Suffix:
Gender:F
Credentials:RN, ACNP, GNP
Other - Prefix:
Other - First Name:SHIH-TING
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, ACNP, GNP
Mailing Address - Street 1:17631 MAIDSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-3821
Mailing Address - Country:US
Mailing Address - Phone:562-324-9271
Mailing Address - Fax:
Practice Address - Street 1:17631 MAIDSTONE AVE
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-3821
Practice Address - Country:US
Practice Address - Phone:562-324-9271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-07
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA501059163W00000X
CA14744363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology