Provider Demographics
NPI:1649919861
Name:VONG, KRISTINE QUYNH ANH (APRN)
Entity type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:QUYNH ANH
Last Name:VONG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 PLANTERS PEAK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-3208
Mailing Address - Country:US
Mailing Address - Phone:832-692-6586
Mailing Address - Fax:
Practice Address - Street 1:3106 PLANTERS PEAK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-3208
Practice Address - Country:US
Practice Address - Phone:832-692-6586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-04
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF05220724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily