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NPI Code Detail

MEDICARE: NOU P THAO RN

MEDICARE: NOU P THAO RN
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
1163W00000XRegistered Nurse95247822CA

General Provider Information

NPI Number : 1558071076
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOU P THAO RN
Provider Business Mailing Address
First Line : 3030 EXPLORER DR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95827-2728
Country : US
Telephone Number : 916-642-1867
Fax Number :
Provider Business Practice Location Address
First Line : 3030 EXPLORER DR
Second Line :
City : SACRAMENTO
State : CA
Zip : 95827-2728
Country : US
Telephone Number : 916-642-1867
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2022
Last Update Date : 11/28/2022

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