Lydia Phan
Nurse Practitioner - Acute Care
3500 E Fletcher Ave Ste 129
Tampa
, Florida 33613-4709
Lydia Phan
Nurse Practitioner - Acute Care
3500 E Fletcher Ave Ste 129
Tampa
, Florida 33613-4709
(772) 333-6108
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About
Features
Specialties
- Nurse Practitioner - Acute Care
Languages spoken
- English
Location
First Address
- Lydia Phan
- 19558 Timberbluff Dr
- Land O Lakes, FL
- Zip : 34638-2588
- Phone : (772) 333-6108
Second Address
- Lydia Phan
- 3500 E Fletcher Ave Ste 129
- Tampa, FL
- Zip : 33613-4709
- Phone : (813) 751-9727
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LA2100X | Nurse Practitioner - Acute Care | ARNP9312946 | FL |
National Provider Identifier
| NPI | 1023511151 |
|---|---|
| Provider Name | Lydia Phan |
| First Address | Land O Lakes, FL 34638-2588 |
| Second Address | Tampa, FL 33613-4709 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/03/2018 |
| Last Update Date | 15/03/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 9312946 | MEDICAL LICENSE (01) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.