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General NPI Number Information
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NPI Number | 1992242697
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Entity Type | Individual
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Provider Name | LAN NGUYEN CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/19/2017
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 4201 BELFORT RD
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City | JACKSONVILLE
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State | FL
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Zip | 32216-1431
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Country | US
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Telephone | 904-296-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 370 BARBADOS DR
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City | PONTE VEDRA
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State | FL
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Zip | 32081-1510
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Country | US
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Telephone | 571-331-0647
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN11001963
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024174405
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License Number State | VA
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