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Individual
MS. SO-FONG WONG
Active
Individual
MS. SO-FONG WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, CNS, CDE
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
21210407
TX
363LF0000X
Family Nurse Practitioner
654824
TX
363LF0000X
Family Nurse Practitioner
Primary
AP110586
TX
364SA2200X
Adult Health Clinical Nurse Specialist
654824
TX
364SA2200X
Adult Health Clinical Nurse Specialist
AP110586
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093873001
TPI
—
01
—
CN8558
PTAN
—
Enumeration date
01/19/2006
Last updated
08/05/2016
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