Provider Demographics
NPI:1831722370
Name:SAGE, CHI-YING DIANA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:CHI-YING
Middle Name:DIANA
Last Name:SAGE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2818
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50704-2818
Mailing Address - Country:US
Mailing Address - Phone:319-235-3568
Mailing Address - Fax:319-235-5013
Practice Address - Street 1:1753 W RIDGEWAY AVE STE 103A
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-4521
Practice Address - Country:US
Practice Address - Phone:319-235-3568
Practice Address - Fax:319-235-5013
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-12
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA157738363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily