Healthcare Provider Details

I. General information

NPI: 1306425095
Provider Name (Legal Business Name): KATHERINE VU APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2840 LEGACY DR
FRISCO TX
75034-6049
US

IV. Provider business mailing address

1220 HORSEMINT DR
LITTLE ELM TX
75068-4679
US

V. Phone/Fax

Practice location:
  • Phone: 972-668-7110
  • Fax:
Mailing address:
  • Phone: 318-792-2241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number828913
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1099860
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: