Basic Information
Provider Information
NPI: 1780219253
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOANG
FirstName: DUONG
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2900 S 70TH STREET
Address2: SUITE # 450
City: LINCOLN
State: NE
PostalCode: 685063796
CountryCode: US
TelephoneNumber: 4024894186
FaxNumber: 4024895279
Practice Location
Address1: 2900 S 70TH STREET
Address2:  
City: LINCOLN
State: NE
PostalCode: 685063796
CountryCode: US
TelephoneNumber: 4024894186
FaxNumber: 4024895279
Other Information
ProviderEnumerationDate: 03/05/2020
LastUpdateDate: 05/29/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/29/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X101581NEY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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