Provider Demographics
NPI:1578285359
Name:NGUYEN, MARIE ANTOINETTE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:ANTOINETTE
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12016 WORTHWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-4157
Mailing Address - Country:US
Mailing Address - Phone:214-226-2758
Mailing Address - Fax:
Practice Address - Street 1:312 E RENFRO ST STE 105
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-3948
Practice Address - Country:US
Practice Address - Phone:817-968-5756
Practice Address - Fax:817-989-2716
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1094038363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily