Healthcare Provider Details

I. General information

NPI: 1003103680
Provider Name (Legal Business Name): KATHERINE M NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2011
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 MONTGOMERY RD SUITE 2B
CINCINNATI OH
45242-7789
US

IV. Provider business mailing address

9200 MONTGOMERY RD SUITE 2B
CINCINNATI OH
45242-7789
US

V. Phone/Fax

Practice location:
  • Phone: 513-891-8700
  • Fax: 513-891-8703
Mailing address:
  • Phone: 513-891-8700
  • Fax: 513-891-8703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA.01780
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: