MEDICARE: HOA MI 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	163W00000X	Registered Nurse	95186647	CA

General Provider Information

NPI Number	:	1437813219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOA MI NGUYEN

Provider Business Mailing Address
First Line	:	2955 E PERALTA WAY APT 102
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93703-3153
Country	:	US
Telephone Number	:	559-824-2039
Fax Number	:

Provider Business Practice Location Address
First Line	:	2955 E PERALTA WAY APT 102
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93703-3153
Country	:	US
Telephone Number	:	559-824-2039
Fax Number	:

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

Provider Enumeration Date	:	10/27/2021
Last Update Date	:	10/27/2021

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Directions to “ HOA MI NGUYEN ” Practice Location

Language	Start Address	Practice Location

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