Provider Demographics
NPI:1730726084
Name:CHIEU, TAM THANH (DNP)
Entity type:Individual
Prefix:
First Name:TAM
Middle Name:THANH
Last Name:CHIEU
Suffix:
Gender:F
Credentials:DNP
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Other - First Name:
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Mailing Address - Street 1:7450 KESSLER ST STE 110
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2550
Mailing Address - Country:US
Mailing Address - Phone:913-831-1003
Mailing Address - Fax:913-831-4801
Practice Address - Street 1:7450 KESSLER ST STE 110
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2550
Practice Address - Country:US
Practice Address - Phone:913-831-1003
Practice Address - Fax:913-831-4801
Is Sole Proprietor?:No
Enumeration Date:2019-12-05
Last Update Date:2022-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2019032482363L00000X
KS53-78798-052363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner