Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ivy Kim Long Phan, APRN

Individual provider Adult Health Nurse Practitioner · NPI 1134902745

Ivy Kim Long Phan, APRN is a Nurse Practitioner in Orlando, Florida. Qualified in 2023, 3 years ago. Practices with Orlando Health Medical Group Inc, a 2,137-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
3
Licensed in
FL
In the registry since
2023
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

1012 Lucerne Ter
Orlando, FL 32806-1015
Phone: (407) 423-1039
Fax: (407) 425-2347
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence APRN11028195 (FL)

Record details

NPI number1134902745
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorNo
NPI enumeratedAugust 16, 2023
Last updated in NPPESNovember 21, 2023
Certification dateNovember 21, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Orlando Health Medical Group Inc — 2137 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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