Antoinette Marie Nguyen, NNP-BC

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

95000839 Issued in CA

Practice address

1441 Florida Ave
Modesto, CA 95350-4404

Phone

(209) 578-1211

NPI assigned

Aug 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Antoinette Marie Eder Former name

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": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1538715040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SATURN CT",
            "city": "PITTSBURG",
            "state": "CA",
            "postal_code": "945657918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "209-578-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANTOINETTE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "CA",
            "license": "689210",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "CA",
            "license": "95000839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTOINETTE",
            "last_name": "EDER",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "NNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sean Nguyen Pham
• Alice Nguyen
• An Duy Nguyen, DMD
• Anh D Nguyen, PHARM.D
• Anna Nguyen
• Brenda H.T. Nguyen, MHS, PA-C
• Catherine Nguyen, MD
• Dang Cong Nguyen, D.O.
• Dat Tien Nguyen, MD
• Elizabeth Nguyen

• Critical Care Neonatal Nurse Practitioner in Modesto, CA
• Providers in Modesto, CA by specialty
• Critical Care Neonatal Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.