Provider Demographics
NPI:1124859384
Name:HOANG, MINH DUC (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:MINH
Middle Name:DUC
Last Name:HOANG
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 HALLMARK AVE N
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-5436
Mailing Address - Country:US
Mailing Address - Phone:651-278-8082
Mailing Address - Fax:651-286-2999
Practice Address - Street 1:1502 HALLMARK AVE N
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-5436
Practice Address - Country:US
Practice Address - Phone:651-278-8082
Practice Address - Fax:651-286-2999
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2336918163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse