Provider Demographics
NPI:1083909519
Name:HOU, NAN NAN (PA-C)
Entity Type:Individual
Prefix:
First Name:NAN NAN
Middle Name:
Last Name:HOU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:HOU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1901 SE 18TH AVE. SUITE 101
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471
Mailing Address - Country:US
Mailing Address - Phone:352-622-3360
Mailing Address - Fax:352-629-4512
Practice Address - Street 1:1901 SE 18TH AVE., SUITE 101
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-622-3360
Practice Address - Fax:352-629-4512
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105710363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant