Provider Demographics
NPI:1528362803
Name:NGO, TRUC THANH (CRNA)
Entity Type:Individual
Prefix:MISS
First Name:TRUC
Middle Name:THANH
Last Name:NGO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9068 COTTAGE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-8607
Mailing Address - Country:US
Mailing Address - Phone:225-926-9141
Mailing Address - Fax:
Practice Address - Street 1:9068 COTTAGE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-8607
Practice Address - Country:US
Practice Address - Phone:225-926-9141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-31
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN115321163W00000X
LARN115321-AP06337367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse