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Individual

MARANDA NGUYEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
11725 W 112TH ST, OVERLAND PARK, KS 66210-2761
(913) 469-5579
(913) 338-1311
Mailing address
PO BOX 741331, ATLANTA, GA 30374-1331
(913) 469-0503
(913) 338-1311

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-46896
KS
207Q00000X
Family Medicine Physician
2021025345
MO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/27/2018
Last updated
10/13/2022
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