Provider Demographics
NPI:1912789173
Name:TU, NGUYEN
Entity Type:Individual
Prefix:
First Name:NGUYEN
Middle Name:
Last Name:TU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 BERKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-6122
Mailing Address - Country:US
Mailing Address - Phone:626-988-3138
Mailing Address - Fax:
Practice Address - Street 1:2700 BERKSHIRE DR
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-6122
Practice Address - Country:US
Practice Address - Phone:626-988-3138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide