Provider Demographics
NPI:1578455945
Name:NGUYEN, KAITLYN KIEU (RN)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:KIEU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MY KIEU
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5660 S 96TH CT APT 16
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3386
Mailing Address - Country:US
Mailing Address - Phone:951-644-9151
Mailing Address - Fax:
Practice Address - Street 1:6363 GROVER ST TRLR 103
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-4325
Practice Address - Country:US
Practice Address - Phone:531-203-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant