Provider Demographics
NPI:1730543026
Name:NGUYEN, AMY (ARNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6237 SEMINOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-6838
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 UNIVERSITY TOWN CENTER DR
Practice Address - Street 2:STE 250A
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-4118
Practice Address - Country:US
Practice Address - Phone:941-677-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9355763363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily