MEDICARE: MR. PHUC H NGUYEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171W00000X	Contractor	11156430	NE

General Provider Information

NPI Number	:	1114817087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PHUC H NGUYEN

Provider Business Mailing Address
First Line	:	5330 N 15TH ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68521-5216
Country	:	US
Telephone Number	:	402-770-2367
Fax Number	:

Provider Business Practice Location Address
First Line	:	2326 U ST
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68503-3059
Country	:	US
Telephone Number	:	402-770-2367
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2025
Last Update Date	:	07/03/2025

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Directions to “ MR. PHUC H NGUYEN ” Practice Location

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