Provider Demographics
NPI:1750037578
Name:TRAN, THI NGOC UYEN (APRN)
Entity Type:Individual
Prefix:
First Name:THI
Middle Name:NGOC UYEN
Last Name:TRAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4098 DINNER LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33859-2105
Mailing Address - Country:US
Mailing Address - Phone:863-273-7769
Mailing Address - Fax:
Practice Address - Street 1:1287 N SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3530
Practice Address - Country:US
Practice Address - Phone:407-273-9410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11018431363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner