Provider Demographics
NPI:1609181742
Name:NGUYEN, THUY LISA (PHARM D)
Entity type:Individual
Prefix:
First Name:THUY
Middle Name:LISA
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3671 JOOR RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-3104
Mailing Address - Country:US
Mailing Address - Phone:225-924-3880
Mailing Address - Fax:225-924-9753
Practice Address - Street 1:3671 JOOR RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70814-3104
Practice Address - Country:US
Practice Address - Phone:225-924-3880
Practice Address - Fax:225-924-9753
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist