Healthcare Provider Details

I. General information

NPI: 1952292559
Provider Name (Legal Business Name): OANH NGO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2025
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3527 W TRUMAN BLVD STE 100A
JEFFERSON CITY MO
65109-5902
US

IV. Provider business mailing address

PO BOX 843966
KANSAS CITY MO
64184-3966
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-8910
  • Fax: 573-893-1984
Mailing address:
  • Phone: 573-884-3300
  • Fax: 573-884-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025028305
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: