Provider Demographics
NPI:1073136479
Name:NGUYEN, ANNIE L (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:L
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 NW 88TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-2700
Mailing Address - Country:US
Mailing Address - Phone:816-746-9800
Mailing Address - Fax:816-587-3555
Practice Address - Street 1:5151 NW 88TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-2700
Practice Address - Country:US
Practice Address - Phone:816-746-9800
Practice Address - Fax:816-587-3555
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2152152W00000X
MO2020013169152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist