Provider Demographics
NPI:1710528732
Name:NGUYEN, THU DIEM (ACNP)
Entity Type:Individual
Prefix:MS
First Name:THU
Middle Name:DIEM
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S POINTE DR APT 501
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-7339
Mailing Address - Country:US
Mailing Address - Phone:786-863-4875
Mailing Address - Fax:
Practice Address - Street 1:800 WEST AVE APT 520
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-5581
Practice Address - Country:US
Practice Address - Phone:786-863-4875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-01
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004800363LA2100X
NY1469229363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care