Individual
NGOC-THU THI PHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4300 W HOUSTON ST, BROKEN ARROW, OK 74012-4519
(918) 254-5000
Mailing address
5132 N ELSTON AVE, CHICAGO, IL 60630-2429
(847) 235-6130
(847) 235-6135
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0103714
OK
Other
Enumeration date
06/11/2020
Last updated
06/24/2020
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