Individual
MISS NGAN NGOC PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NA
Contact information
Practice address
4300 LONDONDERRY RD, HARRISBURG, PA 17109-5317
(717) 920-4300
Mailing address
513 N 48TH ST, HARRISBURG, PA 17111-3623
(717) 343-5533
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5402323769
—
PA
Enumeration date
05/12/2021
Last updated
05/12/2021
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