Provider Demographics
NPI:1225332588
Name:DANG, THUY-TIEN THI (APN)
Entity Type:Individual
Prefix:
First Name:THUY-TIEN
Middle Name:THI
Last Name:DANG
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 NE 95TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-3119
Mailing Address - Country:US
Mailing Address - Phone:816-436-1572
Mailing Address - Fax:816-983-6845
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:816-234-3970
Practice Address - Fax:816-983-6845
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010026979363LF0000X
KS53-75266-061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily