Healthcare Provider Details

I. General information

NPI: 1558294496
Provider Name (Legal Business Name): ANH NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 W ESPLANADE AVE
KENNER LA
70065-2467
US

IV. Provider business mailing address

1854 E CARRIAGE HOUSE DR
BATON ROUGE LA
70815-5543
US

V. Phone/Fax

Practice location:
  • Phone: 504-468-8600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: