MEDICARE: MRS. KIM THI NGUYEN NP

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
1	363LF0000X	Family Nurse Practitioner	026437	OH

General Provider Information

NPI Number	:	1932712601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KIM THI NGUYEN NP

Provider Business Mailing Address
First Line	:	PO BOX 932958
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0028
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2921 W ALEX BELL RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45459-1127
Country	:	US
Telephone Number	:	937-991-3601
Fax Number	:	937-991-2602

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2020
Last Update Date	:	07/08/2025

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