Provider Demographics
NPI:1356792196
Name:HO, DUONG THUY (FNP-C)
Entity type:Individual
Prefix:
First Name:DUONG
Middle Name:THUY
Last Name:HO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 KAMMERER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-6839
Mailing Address - Country:US
Mailing Address - Phone:314-814-2921
Mailing Address - Fax:
Practice Address - Street 1:12774 BOENKER LN
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2436
Practice Address - Country:US
Practice Address - Phone:314-291-7997
Practice Address - Fax:314-678-0583
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016005208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily