Provider Demographics
NPI:1669073557
Name:NGUYEN, DIEMNAM NETTIE (PHARMD)
Entity type:Individual
Prefix:
First Name:DIEMNAM
Middle Name:NETTIE
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 1:1028 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-4904
Mailing Address - Country:US
Mailing Address - Phone:540-886-4208
Mailing Address - Fax:540-886-6205
Practice Address - Street 1:1028 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-4904
Practice Address - Country:US
Practice Address - Phone:540-886-4208
Practice Address - Fax:540-886-6205
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202218088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist