Provider Demographics
NPI:1083218275
Name:NGUYEN, NGHIA STEVEN
Entity Type:Individual
Prefix:
First Name:NGHIA
Middle Name:STEVEN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 E LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-8989
Mailing Address - Country:US
Mailing Address - Phone:775-332-1004
Mailing Address - Fax:
Practice Address - Street 1:1550 E LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-8989
Practice Address - Country:US
Practice Address - Phone:775-332-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20274183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist