Phuong Phan, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2272283 Issued in MA

Practice address

529 Main St
Suite 216
Charlestown, MA 02129-1125

Phone

(617) 895-6488

NPI assigned

Aug 8, 2012

Last updated

Aug 8, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1033466040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 CHARGER ST",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021512003",
            "telephone_number": "617-938-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 MAIN ST",
            "address_2": "SUITE 216",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021291125",
            "telephone_number": "617-895-6488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "PHUONG",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2272283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Pedrick
• Karissa Leester Nicole Peoples, LICSW
• Nicholas Pepe, MD
• Jody Petersen
• Neil Peterson
• Kaitlin Marie Picard, CNP
• Maurisseau Pierre, CPT
• Julie Piotrowski, RN, MSN, PNP, COCN
• Roger K Pitman, MD
• Ginger Polich, M.D.

• Family Nurse Practitioner in Charlestown, MA
• Providers in Charlestown, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.