Provider Demographics
NPI:1073065876
Name:TON, QUYEN NU
Entity Type:Individual
Prefix:
First Name:QUYEN
Middle Name:NU
Last Name:TON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:QUYEN
Other - Middle Name:HANU
Other - Last Name:TON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3571 W 10400 S
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095
Mailing Address - Country:US
Mailing Address - Phone:801-533-5297
Mailing Address - Fax:
Practice Address - Street 1:3571 W 10400 S
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095
Practice Address - Country:US
Practice Address - Phone:801-523-5297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6098814-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist