Healthcare Provider Details

I. General information

NPI: 1922468172
Provider Name (Legal Business Name): AMY NGUYEN HOANG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY THAO NGUYEN NP

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 06/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 HENNESSY BLVD STE 211
BATON ROUGE LA
70808-4365
US

IV. Provider business mailing address

7777 HENNESSY BLVD STE 211
BATON ROUGE LA
70808-4365
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-7163
  • Fax:
Mailing address:
  • Phone: 225-765-7163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP08698
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: