Provider Demographics
NPI:1881296507
Name:NGUYEN, TUYEN M (PHARMACIST)
Entity type:Individual
Prefix:
First Name:TUYEN
Middle Name:M
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2364
Mailing Address - Country:US
Mailing Address - Phone:913-648-5335
Mailing Address - Fax:
Practice Address - Street 1:7701 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-2364
Practice Address - Country:US
Practice Address - Phone:913-648-5335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018040051183500000X
KS1-106790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2018040051OtherPHARMACIST LICENSE
KS1-106790OtherPHARMACIST LICENSE