Individual
AGNES TAN
Active
Individual
AGNES TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
95004938
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95004938
NURSE PRACTITIONER LICENSE
CA
Enumeration date
09/12/2016
Last updated
12/06/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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