Provider Demographics
NPI:1083382972
Name:NGO, QUYNH (NP)
Entity Type:Individual
Prefix:
First Name:QUYNH
Middle Name:
Last Name:NGO
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 1:2020 TECHNOLOGY PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-9411
Mailing Address - Country:US
Mailing Address - Phone:717-731-0101
Mailing Address - Fax:717-731-8359
Practice Address - Street 1:2020 TECHNOLOGY PKWY STE 201
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9411
Practice Address - Country:US
Practice Address - Phone:717-731-0101
Practice Address - Fax:717-731-8359
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN634240163W00000X
VA0024182277363LA2100X
PASP025050363LA2100X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care