Healthcare Provider Details

I. General information

NPI: 1407204266
Provider Name (Legal Business Name): VINCENT CHI NGUYEN DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2016
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4897 BUFORD HWY STE 167
CHAMBLEE GA
30341-3670
US

IV. Provider business mailing address

4897 BUFORD HWY STE 167
CHAMBLEE GA
30341-3670
US

V. Phone/Fax

Practice location:
  • Phone: 770-872-8141
  • Fax: 770-872-8142
Mailing address:
  • Phone: 770-872-8141
  • Fax: 770-872-8142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP288457
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: