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General NPI Number Information
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NPI Number | 1336519396
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Entity Type | Individual
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Provider Name | RUBIE NGUYEN
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Gender | Female
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Dates
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Enumeration Date | 10/03/2015
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Last Update Date | 10/03/2015
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Provider Practice Location Address
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Address Line | 3151 E 7TH ST
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City | JOPLIN
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State | MO
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Zip | 64801-5581
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Country | US
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Telephone | 417-206-3377
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Fax |
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Provider Business Mailing Address
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Address Line | 307 N MAPLE AVE
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City | JOPLIN
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State | MO
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Zip | 64801-3487
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Country | US
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Telephone | 417-413-8948
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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 | 20150333412
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS53314
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License Number State | FL
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