Individual
LY KHANH NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
188 QUINCY AVE UNIT B2, QUINCY, MA 02169-6774
(857) 381-9500
Mailing address
404 CAMINO DEL RIO S STE 102, SAN DIEGO, CA 92108-3586
(800) 316-6314
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
R2344751
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2344751
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/01/2024
Last updated
11/01/2024
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