Provider Demographics
NPI:1801351978
Name:NGUYEN, ANNE P (PA-C)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:P
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-2121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4933 TAMIAMI TRAIL N
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3028
Practice Address - Country:US
Practice Address - Phone:727-291-9538
Practice Address - Fax:727-293-5154
Is Sole Proprietor?:No
Enumeration Date:2019-02-04
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA031960363A00000X
FLPA9112215363A00000X
MDC0007125363A00000X
VA0110-007718363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant