Provider Demographics
NPI:1477956373
Name:NGUYEN, LAN VU (NP)
Entity Type:Individual
Prefix:
First Name:LAN
Middle Name:VU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N WOLFE ST
Mailing Address - Street 2:MEYER 1-130
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:443-444-4714
Mailing Address - Fax:443-444-4770
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:MEYER 1-130
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:443-444-4714
Practice Address - Fax:443-444-4770
Is Sole Proprietor?:No
Enumeration Date:2014-10-06
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2284871363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health