Provider Demographics
NPI:1932444817
Name:LE, NINA HOANG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:HOANG
Last Name:LE
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 1:3368 E SUNNYDALE DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-7312
Mailing Address - Country:US
Mailing Address - Phone:480-433-5394
Mailing Address - Fax:
Practice Address - Street 1:1415 N ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-1616
Practice Address - Country:US
Practice Address - Phone:480-293-0053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS014795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist