Healthcare Provider Details

I. General information

NPI: 1497154371
Provider Name (Legal Business Name): THAO LINH NGUYEN D.P.M
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 E LINWOOD BLVD
KANSAS CITY MO
64128-2226
US

IV. Provider business mailing address

4801 E LINWOOD BLVD
KANSAS CITY MO
64128-2226
US

V. Phone/Fax

Practice location:
  • Phone: 316-993-9736
  • Fax:
Mailing address:
  • Phone: 816-861-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberN006821
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN006821
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN006821
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: