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General NPI Number Information
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NPI Number | 1528510146
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Entity Type | Individual
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Provider Name | HONG DIEM NGUYEN NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/31/2016
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Last Update Date | 10/31/2016
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Provider Practice Location Address
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Address Line | 191 LAMAR HALEY PKWY
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City | CANTON
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State | GA
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Zip | 30114-8019
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Country | US
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Telephone | 770-704-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 716 SUHOLDEN CIR
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City | MARIETTA
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State | GA
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Zip | 30066-3760
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Country | US
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Telephone | 770-601-6308
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN228970
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License Number State | GA
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