Provider Demographics
NPI:1881785640
Name:NGO, JENNY THAO (CNM)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:THAO
Last Name:NGO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4844 ALBEMARLE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205
Mailing Address - Country:US
Mailing Address - Phone:704-536-7233
Mailing Address - Fax:704-536-7581
Practice Address - Street 1:4844 ALBEMARLE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205
Practice Address - Country:US
Practice Address - Phone:704-536-7233
Practice Address - Fax:704-536-7581
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2008-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC12218367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife