MEDICARE: KHANH-LINH HOANG NGUYEN NP-C

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	363LF0000X	Family Nurse Practitioner	95018025	CA
2	363L00000X	Nurse Practitioner	2021024182	MO

General Provider Information

NPI Number	:	1730759531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHANH-LINH HOANG NGUYEN NP-C

Provider Business Mailing Address
First Line	:	9000 N OREGON AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64154-1547
Country	:	US
Telephone Number	:	310-349-7296
Fax Number	:

Provider Business Practice Location Address
First Line	:	8144 NW PRAIRIE VIEW RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-1020
Country	:	US
Telephone Number	:	816-505-3669
Fax Number	:

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

Provider Enumeration Date	:	06/25/2021
Last Update Date	:	08/06/2022

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