Healthcare Provider Details

I. General information

NPI: 1588942791
Provider Name (Legal Business Name): HUONG TRINH THI NGUYEN NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2011
Last Update Date: 04/08/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-0004
US

IV. Provider business mailing address

8901 WISCONSIN AVE
BETHESDA MD
20889-0004
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-5165
  • Fax: 301-295-5170
Mailing address:
  • Phone: 301-295-5165
  • Fax: 301-295-5170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR145153
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: