Provider Demographics
NPI:1013747633
Name:TRAN, NINA (FNP-BC)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:TRAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:772 SW 49TH DR
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-5531
Mailing Address - Country:US
Mailing Address - Phone:503-206-2253
Mailing Address - Fax:
Practice Address - Street 1:180 NE 192ND AVE STE 505
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-7511
Practice Address - Country:US
Practice Address - Phone:503-305-6262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10030454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily