Provider Demographics
NPI:1417371147
Name:VUE, PA KOU
Entity Type:Individual
Prefix:
First Name:PA KOU
Middle Name:
Last Name:VUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4032 E HAMPTON WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4510
Mailing Address - Country:US
Mailing Address - Phone:209-639-3830
Mailing Address - Fax:
Practice Address - Street 1:4032 E HAMPTON WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4510
Practice Address - Country:US
Practice Address - Phone:209-639-3830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA792401163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse