Provider Demographics
NPI:1881394856
Name:NGUYEN, CLARICE L (FNP-BC)
Entity type:Individual
Prefix:
First Name:CLARICE
Middle Name:L
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7355 BARLITE BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1341
Mailing Address - Country:US
Mailing Address - Phone:726-268-7620
Mailing Address - Fax:726-268-7621
Practice Address - Street 1:7355 BARLITE BLVD STE 501
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1341
Practice Address - Country:US
Practice Address - Phone:726-268-7620
Practice Address - Fax:726-268-7621
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1112481363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily