Basic Information
| Provider Information | |||||||||
| NPI: | 1073272464 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | VANESSA | ||||||||
| MiddleName: | NHU THUY | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 807 S PECKHAM CT | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672301900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3165187108 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9211 E 21ST ST N | ||||||||
| Address2: | |||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672062900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3166094400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2021 | ||||||||
| LastUpdateDate: | 12/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 53-80675 | KS | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.