Provider Demographics
NPI:1851940944
Name:NGUYEN, TUONG-MY THI (PHARMD)
Entity Type:Individual
Prefix:
First Name:TUONG-MY
Middle Name:THI
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 1:1005 BLACK WALNUT TRL
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-1914
Mailing Address - Country:US
Mailing Address - Phone:850-221-8495
Mailing Address - Fax:
Practice Address - Street 1:1005 BLACK WALNUT TRL
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-1914
Practice Address - Country:US
Practice Address - Phone:850-221-8495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS59964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist