Individual
DR. LISA MY NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
340 E 1ST AVE STE 101, BROOMFIELD, CO 80020-2444
(303) 544-3800
(303) 463-7182
Mailing address
16 LAKESIDE LN, DENVER, CO 80212-7413
(303) 422-2236
(720) 360-0266
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50041
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08626332
—
CO
Enumeration date
03/25/2009
Last updated
06/25/2021
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