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General NPI Number Information
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NPI Number | 1164906533
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Entity Type | Individual
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Provider Name | THUHAU THI NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 2212 FELLOWSHIP RD
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City | TUCKER
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State | GA
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Zip | 30084-4609
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Country | US
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Telephone | 678-936-6625
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Fax | 678-580-2023
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Provider Business Mailing Address
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Address Line | 2212 FELLOWSHIP RD
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City | TUCKER
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State | GA
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Zip | 30084-4609
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Country | US
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Telephone | 167-893-6662
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 067-R-1729
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License Number State | GA
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