Provider Demographics
NPI:1013413996
Name:NGUYEN, NOEL (RN)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 VALENTINE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-3016
Mailing Address - Country:US
Mailing Address - Phone:413-237-2396
Mailing Address - Fax:
Practice Address - Street 1:5 VALENTINE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01108-3016
Practice Address - Country:US
Practice Address - Phone:413-237-2396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-01
Last Update Date:2018-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT138991163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical