Doctor Name: | MRS. HANG MY-THI NGUYEN |
NPI Number: | 1114291184 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R884274 |
Business Practice Address: | 100 Eastbrook Dr Ste 30 Petal, MS - 394656012 |
Business Phone Number: | 6013365393 |
Business Fax Number: | |
Mailing Address: | 100 Eastbrook Dr Ste 30, PETAL |
State: | MS |
Postal Code: | 394656012 |
Phone Number: | 6013365393 |
Fax Number: | |
NPI Enumeration Date: | 03/08/2012 |
NPI Last Update Date: | 08/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R884274 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |