Individual
PHUONG PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
529 MAIN ST, SUITE 216, CHARLESTOWN, MA 02129-1125
(617) 895-6488
Mailing address
176 CHARGER ST, REVERE, MA 02151-2003
(617) 938-7847
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2272283
MA
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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