Provider Demographics
NPI:1811614357
Name:NGUYEN, MY LINH NGOC
Entity type:Individual
Prefix:
First Name:MY LINH
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LINH
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:101 E DAVID DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:NE
Mailing Address - Zip Code:68467-9459
Mailing Address - Country:US
Mailing Address - Phone:402-362-2092
Mailing Address - Fax:
Practice Address - Street 1:101 E DAVID DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-9459
Practice Address - Country:US
Practice Address - Phone:402-362-2092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17657183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist