Provider Demographics
NPI:1932245271
Name:NGUYEN, KAYLA TRAN (DC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:TRAN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 HIGHWAY 7
Mailing Address - Street 2:#J
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4068
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7200 MINNETONKA BLVD
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-3210
Practice Address - Country:US
Practice Address - Phone:952-925-4847
Practice Address - Fax:952-925-4211
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350003833OtherMEDICARE ID