Provider Demographics
NPI:1982038386
Name:NGUYEN, DUNG HOANG (APRN)
Entity Type:Individual
Prefix:
First Name:DUNG
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:817 N EMPORIA ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3709
Mailing Address - Country:US
Mailing Address - Phone:316-268-5927
Mailing Address - Fax:316-291-7940
Practice Address - Street 1:817 N EMPORIA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3709
Practice Address - Country:US
Practice Address - Phone:316-268-5927
Practice Address - Fax:316-291-7940
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-21
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS76113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201083130AMedicaid
110173261OtherMEDICARE