Nelson-Nguyen, Lisa Ingrid
Nelson-Nguyen, Lisa Ingrid is an individual health care provider with primary practice located at 3415 53Rd Ave , Bettendorf IA 52722-6976. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Nelson-Nguyen, Lisa Ingrid can be contacted via phone (563) 742-4370.Contact Information
Primary practice address
3415 53Rd Ave
Bettendorf IA 52722-6976
Phone: (563) 742-4370
Fax: (309) 558-7026
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 01283 | Iowa |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 085001602 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 001283 | Iowa |
Profile Details
| NPI number | 1619964210 |
|---|---|
| LBN Legal business name | Nelson-Nguyen, Lisa Ingrid |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2005 |
| Last updated | Feb 22nd, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619964210 | NPPES |
| Other | 079425 | HEALTH ALLIANCE | |
| Other | 421060724 | HEALTH ALLIANCE | |
| Other | IA0184 | HEALTH ALLIANCE | |
| Other | P06822 | HEALTH ALLIANCE | |
| Other | 5100541 | HEALTH ALLIANCE | |
| MEDICAID | 1619964210 | HEALTH ALLIANCE | |
| MEDICAID | 0080200 | HEALTH ALLIANCE | |
| Other | 42106072484 | HEALTH ALLIANCE |
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