Provider Demographics
NPI:1841226669
Name:DUONG, NANCY THU NGOC (PA-C)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:THU NGOC
Last Name:DUONG
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 1:11800 ATLANTIS PL
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1160
Mailing Address - Country:US
Mailing Address - Phone:770-360-8881
Mailing Address - Fax:770-255-2533
Practice Address - Street 1:11800 ATLANTIS PL
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1160
Practice Address - Country:US
Practice Address - Phone:770-360-8881
Practice Address - Fax:770-255-2533
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0032777363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0032777Medicare ID - Type Unspecified
28BBVSZMedicare UPIN