Healthcare Provider Details

I. General information

NPI: 1972427003
Provider Name (Legal Business Name): ASHLEE HOANG NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WYOMING ST
DAYTON OH
45409-2722
US

IV. Provider business mailing address

5794 BALSAM DR
LIBERTY TOWNSHIP OH
45044-8602
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-8000
  • Fax:
Mailing address:
  • Phone: 513-668-6525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.010491RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: