Provider Demographics
NPI:1376330688
Name:NGUYEN, RANDY
Entity type:Individual
Prefix:
First Name:RANDY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 CHADWICK DR. LINCOLN, NE 68521
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521
Mailing Address - Country:US
Mailing Address - Phone:402-840-7378
Mailing Address - Fax:402-840-7378
Practice Address - Street 1:1023 CHADWICK DR. LINCOLN, NE 68521
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521
Practice Address - Country:US
Practice Address - Phone:402-840-7378
Practice Address - Fax:402-840-7378
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant