Provider Demographics
NPI:1811793466
Name:NANKHATI-THEPVONG, TOUNGTING (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TOUNGTING
Middle Name:
Last Name:NANKHATI-THEPVONG
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:TOUNGTING
Other - Middle Name:
Other - Last Name:NANKHATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8771 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1845
Mailing Address - Country:US
Mailing Address - Phone:559-681-9429
Mailing Address - Fax:
Practice Address - Street 1:8771 N 7TH ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-1845
Practice Address - Country:US
Practice Address - Phone:559-681-9429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF02250181363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner