Individual
VY THUY THAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
2205 JOLLY RD STE B, OKEMOS, MI 48864-3983
(517) 347-4085
Mailing address
PO BOX 639295 DEPT 93394, CINCINNATI, OH 45263-9295
(248) 266-4200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704282499
MI
363LF0000X
Family Nurse Practitioner
4704282499
MI
363LP2300X
Primary Care Nurse Practitioner
Primary
4704282499
MI
Other
Enumeration date
09/14/2015
Last updated
03/05/2025
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