Provider Demographics
NPI:1205535135
Name:LIEN, NHI AI (FNP-C)
Entity type:Individual
Prefix:
First Name:NHI
Middle Name:AI
Last Name:LIEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:NHI
Other - Middle Name:LIEN
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3004 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-4961
Mailing Address - Country:US
Mailing Address - Phone:626-456-3132
Mailing Address - Fax:
Practice Address - Street 1:3004 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-4961
Practice Address - Country:US
Practice Address - Phone:626-456-3132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95024149363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95024149OtherCALIFORNIA NURSE PRACTITIONER LICENSE