Healthcare Provider Details

I. General information

NPI: 1750755757
Provider Name (Legal Business Name): XUAN NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2015
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7915 CONSTITUTION AVE
COLORADO SPRINGS CO
80951-8901
US

IV. Provider business mailing address

2910 S ACADEMY BLVD
COLORADO SPRINGS CO
80916-3004
US

V. Phone/Fax

Practice location:
  • Phone: 719-284-6274
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number18074
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: