Provider Demographics
NPI:1104378454
Name:NGUYEN, TUYEN K
Entity Type:Individual
Prefix:
First Name:TUYEN
Middle Name:K
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 W GERMANTOWN PIKE
Mailing Address - Street 2:100
Mailing Address - City:EAST NORRITON
Mailing Address - State:PA
Mailing Address - Zip Code:19401-1385
Mailing Address - Country:US
Mailing Address - Phone:610-272-8221
Mailing Address - Fax:610-272-5655
Practice Address - Street 1:190 W GERMANTOWN PIKE
Practice Address - Street 2:100
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19401-1385
Practice Address - Country:US
Practice Address - Phone:610-272-8221
Practice Address - Fax:610-272-5655
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058709363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant