Provider Demographics
NPI:1881991289
Name:HUYNH, LYNDA PHUONG (RN)
Entity type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:PHUONG
Last Name:HUYNH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:2700 E 28TH ST
Mailing Address - Street 2:SUITE 170
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2990
Mailing Address - Country:US
Mailing Address - Phone:612-872-1950
Mailing Address - Fax:612-872-1788
Practice Address - Street 1:2700 E 28TH ST
Practice Address - Street 2:SUITE 170
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-2990
Practice Address - Country:US
Practice Address - Phone:612-872-1950
Practice Address - Fax:612-872-1788
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR 198985-8163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1902070584Medicaid