Provider Demographics
NPI:1447432745
Name:DUONG, DAO-TIEN (ARNP)
Entity Type:Individual
Prefix:
First Name:DAO-TIEN
Middle Name:
Last Name:DUONG
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34106-0429
Mailing Address - Country:US
Mailing Address - Phone:239-252-2697
Mailing Address - Fax:239-774-5653
Practice Address - Street 1:419 N 1ST ST
Practice Address - Street 2:
Practice Address - City:IMMOKALEE
Practice Address - State:FL
Practice Address - Zip Code:34142-3150
Practice Address - Country:US
Practice Address - Phone:239-252-2697
Practice Address - Fax:239-774-5653
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9233386363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology