Provider Demographics
NPI:1942945506
Name:QUACH, THUAN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:THUAN
Middle Name:
Last Name:QUACH
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12727 W 118TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1309
Mailing Address - Country:US
Mailing Address - Phone:714-310-9982
Mailing Address - Fax:
Practice Address - Street 1:13351 S ARAPAHO DR
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1520
Practice Address - Country:US
Practice Address - Phone:913-353-3004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-81075-081363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health