Individual
VAN THI HONG PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3913 S SUNSET SQ, GREENFIELD, WI 53220-2517
(414) 243-7844
Mailing address
3913 S SUNSET SQ, GREENFIELD, WI 53220-2517
(414) 243-7844
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
14674-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100272381
—
WI
Enumeration date
01/26/2024
Last updated
09/10/2024
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