Individual
QUYEN MONG NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1818 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-8321
(225) 256-5888
Mailing address
7250 PERKINS RD APT 834, BATON ROUGE, LA 70808-9197
(337) 781-0438
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
332733
LICENSE NUMBER
LA
Enumeration date
07/18/2022
Last updated
08/10/2022
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