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General NPI Number Information
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NPI Number | 1841161973
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Entity Type | Individual
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Provider Name | DUYEN VU THAO TRAN
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Gender | Female
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 3315 BERRYWOOD DR STE 201
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City | COLUMBIA
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State | MO
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Zip | 65201-6571
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Country | US
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Telephone | 573-882-3818
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Fax |
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Provider Business Mailing Address
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Address Line | 402 N KEENE ST
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City | COLUMBIA
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State | MO
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Zip | 65201-8369
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Country | US
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Telephone | 573-882-1515
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Fax | 573-884-0070
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2025039114
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License Number State | MO
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