Provider Demographics
NPI:1215405105
Name:NGUYEN, ANH-THI (NP-C)
Entity Type:Individual
Prefix:
First Name:ANH-THI
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14802 ENTERPRISE DR APT 51D
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-3005
Mailing Address - Country:US
Mailing Address - Phone:954-805-6991
Mailing Address - Fax:
Practice Address - Street 1:9300 JOHN HICKMAN PKWY STE 102
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5937
Practice Address - Country:US
Practice Address - Phone:469-656-4602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily