Provider Demographics
NPI:1861071896
Name:NGUYEN, ANNY (APNP)
Entity type:Individual
Prefix:
First Name:ANNY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BELOIT HEALTH SYSTEM
Mailing Address - Street 2:1969 WEST HART RD
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-2283
Mailing Address - Country:US
Mailing Address - Phone:608-364-5689
Mailing Address - Fax:608-364-5452
Practice Address - Street 1:BELOIT HEALTH SYSTEM
Practice Address - Street 2:1969 WEST HART RD
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-2283
Practice Address - Country:US
Practice Address - Phone:608-364-5689
Practice Address - Fax:608-364-5452
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10837-22363LF0000X
WI10837-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100180456Medicaid