Healthcare Provider Details

I. General information

NPI: 1831492206
Provider Name (Legal Business Name): VY NGO STEPHAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VY TRINH NGO FNP

II. Dates (important events)

Enumeration Date: 12/07/2010
Last Update Date: 06/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7725 N 43RD AVE STE 510
PHOENIX AZ
85051
US

IV. Provider business mailing address

9520 W PALM LANE STE 200
PHOENIX AZ
85037-4403
US

V. Phone/Fax

Practice location:
  • Phone: 877-809-5092
  • Fax: 480-491-6239
Mailing address:
  • Phone: 623-556-8860
  • Fax: 623-876-9559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3857
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: