Provider Demographics
NPI:1265996854
Name:GUERRE, VAN NGO (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:VAN
Middle Name:NGO
Last Name:GUERRE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1771 102ND CIR NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-4770
Mailing Address - Country:US
Mailing Address - Phone:763-228-0774
Mailing Address - Fax:
Practice Address - Street 1:8525 EDINBROOK XING STE 107C
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1967
Practice Address - Country:US
Practice Address - Phone:763-315-5912
Practice Address - Fax:763-315-5916
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2459322163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health