Provider Demographics
NPI:1164053658
Name:NGUYEN, THUYAN THI (APRN)
Entity Type:Individual
Prefix:MS
First Name:THUYAN
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 TAVISTOCK LAKES BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7592
Mailing Address - Country:US
Mailing Address - Phone:833-309-3737
Mailing Address - Fax:321-380-1411
Practice Address - Street 1:8408 N GRADY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1907
Practice Address - Country:US
Practice Address - Phone:813-885-9091
Practice Address - Fax:813-324-1133
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005671363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily