Provider Demographics
NPI:1912288564
Name:NGUYEN, LINH MY (RN, BSN)
Entity Type:Individual
Prefix:
First Name:LINH
Middle Name:MY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 ROLLING OAKS LN
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-2332
Mailing Address - Country:US
Mailing Address - Phone:479-685-4834
Mailing Address - Fax:
Practice Address - Street 1:2400 S 48TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-6683
Practice Address - Country:US
Practice Address - Phone:479-725-5224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR89083163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse