Provider Demographics
NPI:1144744616
Name:MOUA, NANCY SHENG (FNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:SHENG
Last Name:MOUA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 N MCCARTHY BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5119
Mailing Address - Country:US
Mailing Address - Phone:408-582-4113
Mailing Address - Fax:
Practice Address - Street 1:670 N MCCARTHY BLVD STE 220
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5119
Practice Address - Country:US
Practice Address - Phone:408-582-4113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003432207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine