Provider Demographics
NPI:1851773188
Name:TRAN, KELLY THANH QUYNH (NP-C)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:THANH QUYNH
Last Name:TRAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:Q
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP-C
Mailing Address - Street 1:10619 PROFESSIONAL CIR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5831
Mailing Address - Country:US
Mailing Address - Phone:775-852-4848
Mailing Address - Fax:
Practice Address - Street 1:8610 TECHNOLOGY WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5941
Practice Address - Country:US
Practice Address - Phone:775-826-4900
Practice Address - Fax:775-826-3257
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV838559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily