Provider Demographics
NPI:1972040004
Name:NGUYEN, SANDY (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10967 LAKE UNDERHILL RD STE 113
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-4434
Mailing Address - Country:US
Mailing Address - Phone:407-537-9451
Mailing Address - Fax:
Practice Address - Street 1:10967 LAKE UNDERHILL RD STE 113
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4434
Practice Address - Country:US
Practice Address - Phone:407-537-9451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-26
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9359984363LP0808X
OHAPRN.CNP.022506363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health