MEDICARE: TERESA THIEN CA NGUYENTRAN R.N., N.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	572168	NY
2	363LA2200X	Adult Health Nurse Practitioner	305884	NY

General Provider Information

NPI Number	:	1497029342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA THIEN CA NGUYENTRAN R.N., N.P.

Provider Business Mailing Address
First Line	:	7902 LAWN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-4174
Country	:	US
Telephone Number	:	808-741-6823
Fax Number	:

Provider Business Practice Location Address
First Line	:	10201 CARNEGIE AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-2130
Country	:	US
Telephone Number	:	866-223-8100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2012
Last Update Date	:	10/06/2022

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