Provider Demographics
NPI:1861858144
Name:NGUYEN, THIEN TU N
Entity Type:Individual
Prefix:
First Name:THIEN TU
Middle Name:N
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 THOMPSON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-1766
Mailing Address - Country:US
Mailing Address - Phone:678-971-6389
Mailing Address - Fax:678-971-6386
Practice Address - Street 1:1435 THOMPSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1766
Practice Address - Country:US
Practice Address - Phone:678-971-6389
Practice Address - Fax:678-971-6386
Is Sole Proprietor?:No
Enumeration Date:2016-01-03
Last Update Date:2016-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH028220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist