Provider Demographics
NPI:1225738578
Name:NGUYEN, HIEN DIEU (PHARMD)
Entity Type:Individual
Prefix:
First Name:HIEN
Middle Name:DIEU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 CAPISIC ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-1739
Mailing Address - Country:US
Mailing Address - Phone:207-815-1336
Mailing Address - Fax:
Practice Address - Street 1:4993 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:MANCHESTER CENTER
Practice Address - State:VT
Practice Address - Zip Code:05255-9768
Practice Address - Country:US
Practice Address - Phone:802-362-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0134931183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist