Provider Demographics
NPI:1871119305
Name:NGUYEN, CHI KIEU (RPH)
Entity type:Individual
Prefix:
First Name:CHI
Middle Name:KIEU
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-4538
Mailing Address - Country:US
Mailing Address - Phone:269-344-1185
Mailing Address - Fax:269-344-3415
Practice Address - Street 1:760 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-4538
Practice Address - Country:US
Practice Address - Phone:269-344-1185
Practice Address - Fax:269-344-3415
Is Sole Proprietor?:No
Enumeration Date:2020-06-20
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302044562183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist