Provider Demographics
NPI:1962862433
Name:YUE, YUJUAN
Entity type:Individual
Prefix:
First Name:YUJUAN
Middle Name:
Last Name:YUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3885 SHADY POINTE ROW
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-8478
Mailing Address - Country:US
Mailing Address - Phone:317-987-3839
Mailing Address - Fax:
Practice Address - Street 1:918 FRY RD
Practice Address - Street 2:SUITEA
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1819
Practice Address - Country:US
Practice Address - Phone:317-478-7216
Practice Address - Fax:866-371-1656
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-26
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN84000177A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INA7449105AOtherACUPUNCTURE