Individual
MS. LOAN KIM PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1624 N ROCK RD, DERBY, KS 67037-3718
(316) 554-2126
(316) 554-2128
Mailing address
1624 N ROCK RD, DERBY, KS 67037-3718
(316) 554-2126
(316) 554-2128
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-75552-102
KS
Other
Enumeration date
02/10/2012
Last updated
08/15/2019
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