Healthcare Provider Details

I. General information

NPI: 1801718606
Provider Name (Legal Business Name): CHAU NGUYEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 GRISSOM FARM RD
GARNER NC
27529-7001
US

IV. Provider business mailing address

1025 GRISSOM FARM RD
GARNER NC
27529-7001
US

V. Phone/Fax

Practice location:
  • Phone: 919-699-6220
  • Fax:
Mailing address:
  • Phone: 919-699-6220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number262050
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: