Healthcare Provider Details

I. General information

NPI: 1396050506
Provider Name (Legal Business Name): THUY AN DINH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 HIGHWAY 11 N
PICAYUNE MS
39466-2065
US

IV. Provider business mailing address

2209 HIGHWAY 11 N
PICAYUNE MS
39466-2065
US

V. Phone/Fax

Practice location:
  • Phone: 601-799-2087
  • Fax: 601-799-2971
Mailing address:
  • Phone: 601-799-2087
  • Fax: 601-799-2971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17969
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberT-010172
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: