Provider Demographics
NPI:1851931802
Name:NGUYEN, TRAN NGOC (BSN PHN RN)
Entity Type:Individual
Prefix:MISS
First Name:TRAN
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:BSN PHN RN
Other - Prefix:MISS
Other - First Name:TRAN
Other - Middle Name:NGOC
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSN PHN RN
Mailing Address - Street 1:660 S FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-7913
Mailing Address - Country:US
Mailing Address - Phone:408-472-2294
Mailing Address - Fax:
Practice Address - Street 1:660 S FAIR OAKS AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-7913
Practice Address - Country:US
Practice Address - Phone:408-472-2294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95175652163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse