Provider Demographics
NPI:1003303595
Name:NGUON, NANCY (ATC, CPT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:NGUON
Suffix:
Gender:F
Credentials:ATC, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 EVERBREEZE DR
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-1531
Mailing Address - Country:US
Mailing Address - Phone:802-391-7129
Mailing Address - Fax:
Practice Address - Street 1:802 INDUSTRIAL AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-7122
Practice Address - Country:US
Practice Address - Phone:802-863-2272
Practice Address - Fax:802-658-0823
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer