Provider Demographics
NPI:1518197649
Name:NGUYEN, LYNN
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21100 DULLES TOWN CIR
Mailing Address - Street 2:SUITE 290
Mailing Address - City:DULLES
Mailing Address - State:VA
Mailing Address - Zip Code:20166-2437
Mailing Address - Country:US
Mailing Address - Phone:703-421-3359
Mailing Address - Fax:703-421-3428
Practice Address - Street 1:21100 DULLES TOWN CIR
Practice Address - Street 2:SUITE 290
Practice Address - City:DULLES
Practice Address - State:VA
Practice Address - Zip Code:20166-2437
Practice Address - Country:US
Practice Address - Phone:703-421-3359
Practice Address - Fax:703-421-3428
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101003450156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician