Provider Demographics
NPI:1376075762
Name:NGUYEN, QUYEN NGOC (MSN APRN)
Entity Type:Individual
Prefix:
First Name:QUYEN
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MSN APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N EDINBURGH DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4125
Mailing Address - Country:US
Mailing Address - Phone:407-646-7015
Mailing Address - Fax:407-646-7935
Practice Address - Street 1:100 N EDINBURGH DR STE 102
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4125
Practice Address - Country:US
Practice Address - Phone:407-646-7015
Practice Address - Fax:407-646-7935
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9449528363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily