Provider Demographics
NPI:1538210281
Name:TAYLOR, ANH THI-TUYET (OD)
Entity type:Individual
Prefix:DR
First Name:ANH
Middle Name:THI-TUYET
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:ANH
Other - Middle Name:THI-TUYET
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1606 S 72ND ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-1600
Mailing Address - Country:US
Mailing Address - Phone:402-393-9576
Mailing Address - Fax:402-393-9578
Practice Address - Street 1:1606 S 72ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-1600
Practice Address - Country:US
Practice Address - Phone:402-393-9576
Practice Address - Fax:402-393-9578
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2009-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1189152W00000X
NE364152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
U92173Medicare UPIN
NE276010Medicare ID - Type Unspecified