Provider Demographics
NPI:1962008243
Name:ZHU, VINCENT JIE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:JIE
Last Name:ZHU
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1779 LAKELAND HILLS DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1269
Mailing Address - Country:US
Mailing Address - Phone:775-376-3079
Mailing Address - Fax:
Practice Address - Street 1:4600 KIETZKE LN STE G177
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-5041
Practice Address - Country:US
Practice Address - Phone:775-376-3079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV833585363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily