MEDICARE: MR. HUY ANH 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	367500000X	Certified Registered Nurse Anesthetist	358942-8901	UT

General Provider Information

NPI Number	:	1174762801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HUY ANH NGUYEN

Provider Business Mailing Address
First Line	:	3683 HAMPSHIRE CIR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84119-4064
Country	:	US
Telephone Number	:	801-916-8724
Fax Number	:

Provider Business Practice Location Address
First Line	:	3683 HAMPSHIRE CIR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84119-4064
Country	:	US
Telephone Number	:	801-916-8724
Fax Number	:

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

Provider Enumeration Date	:	02/19/2009
Last Update Date	:	02/19/2009

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