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NPI Code Detail

MEDICARE: JESSICA NGUYEN OT, MOT

MEDICARE: JESSICA NGUYEN OT, MOT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist19510CA
2225X00000XOccupational Therapist1703359KS
3225X00000XOccupational Therapist2019010033MO

General Provider Information

NPI Number : 1881174514
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA NGUYEN OT, MOT
Provider Business Mailing Address
First Line : 6397 LEE HWY STE 300
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-4915
Country : US
Telephone Number : 423-238-7217
Fax Number : 423-238-3473
Provider Business Practice Location Address
First Line : 3355 MAIN ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64111-1904
Country : US
Telephone Number : 816-399-0806
Fax Number : 816-743-7413
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2018
Last Update Date : 11/08/2019

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Directions to “ JESSICA NGUYEN OT, MOT” Practice Location

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