Healthcare Provider Details

I. General information

NPI: 1912639261
Provider Name (Legal Business Name): BRITTNEY NGUYEN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 N RODNEY PARHAM RD
LITTLE ROCK AR
72212-4191
US

IV. Provider business mailing address

621 WILDCREEK CIR
LITTLE ROCK AR
72223-8026
US

V. Phone/Fax

Practice location:
  • Phone: 501-830-2020
  • Fax:
Mailing address:
  • Phone: 501-416-3316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2857
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: