Provider Demographics
NPI:1598588642
Name:NGUYEN, PHUONG XUAN (DNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:PHUONG
Middle Name:XUAN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6009 WALHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2621
Mailing Address - Country:US
Mailing Address - Phone:805-539-9734
Mailing Address - Fax:
Practice Address - Street 1:6009 WALHAVEN DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2621
Practice Address - Country:US
Practice Address - Phone:805-539-9734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1045369163W00000X
VA0001287321163W00000X
VA0024191838363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse