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General NPI Number Information
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NPI Number | 1194094235
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Entity Type | Individual
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Provider Name | PHUONG MARY NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 12/19/2011
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Last Update Date | 12/19/2011
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Provider Practice Location Address
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Address Line | 5151 W COLFAX AVE
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City | DENVER
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State | CO
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Zip | 80204-1016
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Country | US
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Telephone | 720-214-1151
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Fax |
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Provider Business Mailing Address
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Address Line | 8841 W POWERS PL
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City | LITTLETON
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State | CO
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Zip | 80123-2319
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Country | US
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Telephone | 720-394-7452
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17575
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License Number State | CO
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