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General NPI Number Information
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NPI Number | 1437405248
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Entity Type | Individual
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Provider Name | ROSA PHUONGCHI NGUYEN FNP
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Gender | Female
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 04/05/2024
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Provider Practice Location Address
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Address Line | 1230 E KINGSLEY ST STE A&B
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City | SPRINGFIELD
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State | MO
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Zip | 65804-7211
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Country | US
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Telephone | 417-336-0033
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Fax | 855-710-6552
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Provider Business Mailing Address
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Address Line | 110 BUSINESS PARK DR STE C
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City | BRANSON
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State | MO
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Zip | 65616-7449
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Country | US
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Telephone | 417-336-0033
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Fax | 855-710-6552
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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 | 2012025989
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License Number State | MO
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