Provider Demographics
NPI:1669297271
Name:NGUYEN, SABRINA KIM (ACNP-AG)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:KIM
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:ACNP-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2679 COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-1542
Mailing Address - Country:US
Mailing Address - Phone:586-214-1752
Mailing Address - Fax:
Practice Address - Street 1:2679 COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1542
Practice Address - Country:US
Practice Address - Phone:586-214-1752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704361939363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care