Healthcare Provider Details

I. General information

NPI: 1801683602
Provider Name (Legal Business Name): VIRGINIA ANN NGUYEN RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 MILL CREEK DR
RINCON GA
31326-5542
US

IV. Provider business mailing address

117 MILL CREEK DR
RINCON GA
31326-5542
US

V. Phone/Fax

Practice location:
  • Phone: 912-346-1055
  • Fax: 912-346-1055
Mailing address:
  • Phone: 912-346-1055
  • Fax: 912-346-1055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT23947
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: