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General NPI Number Information
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NPI Number | 1518087865
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Entity Type | Individual
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Provider Name | NHANHIEN D TRAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | 1317 S DEWEY AVE
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City | WAGONER
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State | OK
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Zip | 74467-7013
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Country | US
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Telephone | 918-485-9696
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Fax | 918-485-1701
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Provider Business Mailing Address
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Address Line | 509 NW 9TH ST
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City | WAGONER
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State | OK
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Zip | 74467-2305
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Country | US
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Telephone | 316-516-4895
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1501107
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License Number State | KS
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