Healthcare Provider Details

I. General information

NPI: 1598596702
Provider Name (Legal Business Name): DALENA NGUYEN DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4035 JOHNS CREEK PKWY STE A
SUWANEE GA
30024-1213
US

IV. Provider business mailing address

4035 JOHNS CREEK PKWY STE A
SUWANEE GA
30024-1213
US

V. Phone/Fax

Practice location:
  • Phone: 470-268-6980
  • Fax: 888-815-1765
Mailing address:
  • Phone: 470-268-6980
  • Fax: 888-815-1765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN299613
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: