Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 209024182 | IL |
N | 363LN0000X | Nurse Practitioner - Neonatal | AP145606 | TX |
NPI | 1205467362 |
---|---|
Provider Name | Angie Tran |
First Address | Houston, TX 77008-6919 |
Second Address | Chicago, IL 60611-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2020 |
Last Update Date | 23/12/2021 |