Provider Demographics
NPI:1548931488
Name:DUONG, PHUONG THI (APRN)
Entity type:Individual
Prefix:MISS
First Name:PHUONG
Middle Name:THI
Last Name:DUONG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:1 CESSNA BLVD BLDG C5
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67215-1400
Mailing Address - Country:US
Mailing Address - Phone:316-517-4000
Mailing Address - Fax:316-517-4040
Practice Address - Street 1:1 CESSNA BLVD BLDG C5
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67215-1400
Practice Address - Country:US
Practice Address - Phone:316-517-4000
Practice Address - Fax:316-517-4040
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS53-80565-102363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care