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Individual
PHUNG KIM PHAM
Active
Individual
PHUNG KIM PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
363LF0000X
Family Nurse Practitioner
Primary
0024194572
VA
Other
Enumeration date
12/09/2019
Last updated
02/04/2026
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