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NPI Code Detail

MEDICARE: VANESSA NGUYEN NP

MEDICARE: VANESSA NGUYEN NP
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
1363LF0000XFamily Nurse Practitioner236684AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205468691
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA NGUYEN NP
Provider Business Mailing Address
First Line : 1400 W VALENCIA RD STE 110
Second Line :
City : TUCSON
State : AZ
Zip : 85746-6006
Country : US
Telephone Number : 520-751-3335
Fax Number :
Provider Business Practice Location Address
First Line : 1400 W VALENCIA RD STE 110
Second Line :
City : TUCSON
State : AZ
Zip : 85746-6006
Country : US
Telephone Number :
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2020
Last Update Date : 02/03/2021

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