Provider Demographics
NPI:1134891823
Name:LE, VAN KHANH (PA-C)
Entity type:Individual
Prefix:MS
First Name:VAN
Middle Name:KHANH
Last Name:LE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:6400 OHIO DR APT 2023
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2665
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:223 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:MT
Practice Address - Zip Code:59270-4106
Practice Address - Country:US
Practice Address - Phone:406-488-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant