Healthcare Provider Details

I. General information

NPI: 1033993498
Provider Name (Legal Business Name): NHI MY TRUONG CRNP, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 9TH STREET DR W
PALMETTO FL
34221-4802
US

IV. Provider business mailing address

3401 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-4319
US

V. Phone/Fax

Practice location:
  • Phone: 941-721-3900
  • Fax: 941-721-7403
Mailing address:
  • Phone: 215-590-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberSP033012
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: