Provider Demographics
NPI:1891404588
Name:VU, HOANG PHUONG NGUYEN
Entity Type:Individual
Prefix:DR
First Name:HOANG
Middle Name:PHUONG NGUYEN
Last Name:VU
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 1:6146 LINTON LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-5361
Mailing Address - Country:US
Mailing Address - Phone:206-877-2001
Mailing Address - Fax:
Practice Address - Street 1:6146 LINTON LN
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-5361
Practice Address - Country:US
Practice Address - Phone:206-877-2001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68309183500000X
IN26030044A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist