Healthcare Provider Details

I. General information

NPI: 1124901491
Provider Name (Legal Business Name): LINH NGOC HOANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 S 70TH ST
LINCOLN NE
68506-4677
US

IV. Provider business mailing address

7031 S 30TH PL
LINCOLN NE
68516-4857
US

V. Phone/Fax

Practice location:
  • Phone: 402-440-5268
  • Fax:
Mailing address:
  • Phone: 402-904-2618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number116188
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: