Healthcare Provider Details

I. General information

NPI: 1962330977
Provider Name (Legal Business Name): MYBRIDGE IN-HOME PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

2851 N 79TH ST
LINCOLN NE
68507-3336
US

IV. Provider business mailing address

2851 N 79TH ST
LINCOLN NE
68507-3336
US

V. Phone/Fax

Practice location:
  • Phone: 402-802-7823
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CUU NGUYEN
Title or Position: NURE PRACTITIONER
Credential: APRN
Phone: 402-802-7823