Provider Demographics
NPI:1518323856
Name:LUONG, NHU THUY (PA-C)
Entity Type:Individual
Prefix:
First Name:NHU
Middle Name:THUY
Last Name:LUONG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 CORONA DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73149-1806
Mailing Address - Country:US
Mailing Address - Phone:405-628-9319
Mailing Address - Fax:
Practice Address - Street 1:15809 NE 23RD ST
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-8428
Practice Address - Country:US
Practice Address - Phone:405-390-9600
Practice Address - Fax:405-390-9400
Is Sole Proprietor?:No
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2579363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant