Provider Demographics
NPI:1346528502
Name:NGUYEN, MICHELLE KIM (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:KIM
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1844
Mailing Address - Country:US
Mailing Address - Phone:615-234-0450
Mailing Address - Fax:
Practice Address - Street 1:342 22ND AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1844
Practice Address - Country:US
Practice Address - Phone:615-327-2001
Practice Address - Fax:615-234-0476
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN53027207W00000X
TNMD53027207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology