Provider Demographics
NPI:1255910485
Name:NGUYEN, CARRIE ANNE (PT, DPT)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANNE
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16251 N CLEVELAND AVE STE 1-4
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-2176
Mailing Address - Country:US
Mailing Address - Phone:239-731-6222
Mailing Address - Fax:239-731-6555
Practice Address - Street 1:16251 N CLEVELAND AVE STE 1-4
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-2176
Practice Address - Country:US
Practice Address - Phone:239-731-6222
Practice Address - Fax:239-731-6555
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT37060225100000X
SC7113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist