Provider Demographics
NPI:1205204716
Name:NGUYEN, TAMMY MY HUYEN (STUDENT)
Entity Type:Individual
Prefix:MISS
First Name:TAMMY
Middle Name:MY HUYEN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1241
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:LA
Mailing Address - Zip Code:70340-1241
Mailing Address - Country:US
Mailing Address - Phone:985-519-3473
Mailing Address - Fax:
Practice Address - Street 1:115-A BETSY CHERAMIE AYO HL
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70310-0001
Practice Address - Country:US
Practice Address - Phone:985-493-2614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program