Healthcare Provider Details

I. General information

NPI: 1992991129
Provider Name (Legal Business Name): VU NGOC NGUYEN RN, CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 N FERRY ST
ANOKA MN
55303-1650
US

IV. Provider business mailing address

2727 N FERRY ST
ANOKA MN
55303-1650
US

V. Phone/Fax

Practice location:
  • Phone: 763-506-1000
  • Fax:
Mailing address:
  • Phone: 763-506-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR1588372
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1588372
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR1588372
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: