Provider Demographics
NPI:1255043550
Name:NGUYEN, KRISTINA (LVN)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7055 CANEVALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-0252
Mailing Address - Country:US
Mailing Address - Phone:916-474-0893
Mailing Address - Fax:
Practice Address - Street 1:7055 CANEVALLEY CIR
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-0252
Practice Address - Country:US
Practice Address - Phone:916-474-0893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA482224164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse