Provider Demographics
NPI:1750878526
Name:LE, LIEN PHUONG (FNP-BC)
Entity type:Individual
Prefix:
First Name:LIEN
Middle Name:PHUONG
Last Name:LE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14747 N NORTHSIGHT BLVD STE 111 #311
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2633
Mailing Address - Country:US
Mailing Address - Phone:602-269-7797
Mailing Address - Fax:602-269-2329
Practice Address - Street 1:3019 N 35TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-5206
Practice Address - Country:US
Practice Address - Phone:602-269-7797
Practice Address - Fax:602-269-2329
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN163637363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily