Provider Demographics
NPI:1194337626
Name:TRAN, LAN PHUONG THUY (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:LAN PHUONG
Middle Name:THUY
Last Name:TRAN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20915 WILDERNESS OAK APT 2204
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-2634
Mailing Address - Country:US
Mailing Address - Phone:408-204-3887
Mailing Address - Fax:
Practice Address - Street 1:20915 WILDERNESS OAK APT 2204
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-2634
Practice Address - Country:US
Practice Address - Phone:408-204-3887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN179297163W00000X
TX1128221367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse