Provider Demographics
NPI:1295022150
Name:NGUYEN, THUY KIM (PHARMD)
Entity Type:Individual
Prefix:
First Name:THUY
Middle Name:KIM
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 1:2201 COBB PKWY SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-7633
Mailing Address - Country:US
Mailing Address - Phone:770-373-2349
Mailing Address - Fax:770-373-2349
Practice Address - Street 1:2201 COBB PKWY SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-7633
Practice Address - Country:US
Practice Address - Phone:770-373-2349
Practice Address - Fax:770-373-2349
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023948183500000X
LA018623183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist