Provider Demographics
NPI:1346782026
Name:NGHIEM, LYNNE L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:L
Last Name:NGHIEM
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 1:9965 NELAS WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-6321
Mailing Address - Country:US
Mailing Address - Phone:916-642-3562
Mailing Address - Fax:
Practice Address - Street 1:9965 NELAS WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-6321
Practice Address - Country:US
Practice Address - Phone:916-642-3562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71401183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist