Healthcare Provider Details

I. General information

NPI: 1811674674
Provider Name (Legal Business Name): NATHAN GWUN-HO YUEN APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST FL 1
LEXINGTON KY
40536-0001
US

IV. Provider business mailing address

343 MANITOBA LN
LEXINGTON KY
40515-4830
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-6542
  • Fax: 859-323-2074
Mailing address:
  • Phone: 617-230-6016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number4002090
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4002090
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: