Provider Demographics
NPI:1396306429
Name:TRUONG, CHRISTINE QUYNH NHU (APRN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:QUYNH NHU
Last Name:TRUONG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:QUYNH NHU
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4338 FLORA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4794
Mailing Address - Country:US
Mailing Address - Phone:321-262-1777
Mailing Address - Fax:
Practice Address - Street 1:1801 LEE RD STE 170
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2167
Practice Address - Country:US
Practice Address - Phone:407-896-2901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002917363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner