Provider Demographics
NPI:1184026957
Name:LE, THANH-XUAN VU (CNM)
Entity type:Individual
Prefix:MRS
First Name:THANH-XUAN
Middle Name:VU
Last Name:LE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:THANH-XUAN
Other - Middle Name:THI
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7050 GALL BLVD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33541-1347
Mailing Address - Country:US
Mailing Address - Phone:813-782-8761
Mailing Address - Fax:
Practice Address - Street 1:7050 GALL BLVD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-1347
Practice Address - Country:US
Practice Address - Phone:813-782-8761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9246908367A00000X
FLAPRN9246908176B00000X
FLARNP 9246908363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013636400Medicaid
FLY0N8WOtherBLUE CROSS BLUE SHIELD
FL013636400Medicaid