Provider Demographics
NPI:1922468172
Name:HOANG, AMY NGUYEN (NP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:NGUYEN
Last Name:HOANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:THAO
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:7777 HENNESSY BLVD STE 211
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4365
Mailing Address - Country:US
Mailing Address - Phone:225-765-7163
Mailing Address - Fax:
Practice Address - Street 1:7777 HENNESSY BLVD STE 211
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4365
Practice Address - Country:US
Practice Address - Phone:225-765-7163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2019-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08698363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily