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General NPI Number Information
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NPI Number | 1245847276
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Entity Type | Individual
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Provider Name | MAI-LINH THI NGUYEN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/24/2020
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 1 BARNES JEWISH HOSPITAL PLZ
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1003
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Country | US
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Telephone | 314-226-4770
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Fax |
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Provider Business Mailing Address
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Address Line | 1 HAIRPIN DR
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City | EDWARDSVILLE
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State | IL
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Zip | 62026-0001
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Country | US
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Telephone | 618-650-5555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2020020529
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License Number State | MO
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