Healthcare Provider Details

I. General information

NPI: 1811883184
Provider Name (Legal Business Name): THAOVY VO NGUYEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10803 DEERING RD
LOUISVILLE KY
40272-4127
US

IV. Provider business mailing address

5707 WAVELAND CIR
PROSPECT KY
40059-8665
US

V. Phone/Fax

Practice location:
  • Phone: 859-375-9200
  • Fax:
Mailing address:
  • Phone: 469-360-2956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4040190
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: