Provider Demographics
NPI:1104396647
Name:HUYNH, KIM NGAN (ACAGNP & FNP)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:NGAN
Last Name:HUYNH
Suffix:
Gender:F
Credentials:ACAGNP & FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10653 EMNORA LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-2008
Mailing Address - Country:US
Mailing Address - Phone:720-323-2853
Mailing Address - Fax:
Practice Address - Street 1:27800 NORTHWEST FWY STE 4201
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-5302
Practice Address - Country:US
Practice Address - Phone:346-231-4628
Practice Address - Fax:303-715-5020
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994327-NP2084N0400X, 363L00000X, 363LA2100X, 363LF0000X
TX1113833363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily