Provider Demographics
NPI:1477947380
Name:NGUYEN, JULIE (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21713 W 93RD TER
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66220-3709
Mailing Address - Country:US
Mailing Address - Phone:816-332-3995
Mailing Address - Fax:
Practice Address - Street 1:21 CORPORATE WOODS, 10870 BENSON DRIVE #2160
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210
Practice Address - Country:US
Practice Address - Phone:833-357-3227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-28
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-50037207Q00000X
ARE-14129207R00000X
VA0101283533207R00000X
PAMD486558207R00000X
SC93314207R00000X
NJ25IA12314300207R00000X
GA100388207R00000X
IL036.163941207R00000X
KS04-41262207R00000X
MO2019045764207R00000X
FLME169806207R00000X
MDD0100817207R00000X
390200000X
KS1477947380207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program