Healthcare Provider Details

I. General information

NPI: 1205220662
Provider Name (Legal Business Name): TIEN T NGUYEN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIEN T NGUYEN FNP-C

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 KRISTINA WAY
CHESAPEAKE VA
23320-8917
US

IV. Provider business mailing address

1421 KRISTINA WAY
CHESAPEAKE VA
23320-8917
US

V. Phone/Fax

Practice location:
  • Phone: 757-389-7300
  • Fax: 757-568-2795
Mailing address:
  • Phone: 757-389-7300
  • Fax: 757-568-2795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001239470
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024172195
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: