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General NPI Number Information
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NPI Number | 1013716703
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Entity Type | Individual
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Provider Name | THUY VUONG NGUYEN TRAN
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Gender | Female
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 5373 W LAKE PARK BLVD
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City | WEST VALLEY CITY
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State | UT
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Zip | 84120-8208
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Country | US
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Telephone | 801-902-8080
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27128
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City | SALT LAKE CITY
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State | UT
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Zip | 84127-0128
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 12076652-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 12076652-4405
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License Number State | UT
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