Healthcare Provider Details

I. General information

NPI: 1477996452
Provider Name (Legal Business Name): LEANN TA NGUYEN PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 06/28/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17761 COTTONWOOD DR
PARKER CO
80134-3925
US

IV. Provider business mailing address

17761 COTTONWOOD DR
PARKER CO
80134-3925
US

V. Phone/Fax

Practice location:
  • Phone: 303-334-9548
  • Fax: 303-334-9559
Mailing address:
  • Phone: 303-334-9548
  • Fax: 303-334-9559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number17827
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: