Provider Demographics
NPI:1396154449
Name:TRUONG, VAN NESS NGUYEN (APRN-FNP)
Entity type:Individual
Prefix:
First Name:VAN NESS
Middle Name:NGUYEN
Last Name:TRUONG
Suffix:
Gender:M
Credentials:APRN-FNP
Other - Prefix:MR
Other - First Name:VAN
Other - Middle Name:NGUYEN
Other - Last Name:TRUONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN-FNP
Mailing Address - Street 1:8337 NW 107TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-4033
Mailing Address - Country:US
Mailing Address - Phone:405-760-0640
Mailing Address - Fax:405-945-5991
Practice Address - Street 1:8337 NW 107TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-4033
Practice Address - Country:US
Practice Address - Phone:405-760-0640
Practice Address - Fax:405-945-5991
Is Sole Proprietor?:No
Enumeration Date:2014-08-02
Last Update Date:2014-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK99647363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily