Healthcare Provider Details

I. General information

NPI: 1386558633
Provider Name (Legal Business Name): CELINE NGUYEN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 S VALLE VERDE DR STE 120130
HENDERSON NV
89012-3462
US

IV. Provider business mailing address

2785 AUCHMULL ST
HENDERSON NV
89044-0214
US

V. Phone/Fax

Practice location:
  • Phone: 702-452-2020
  • Fax:
Mailing address:
  • Phone: 702-882-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1274
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: