Provider Demographics
NPI:1871805747
Name:NGUYEN, THAO THIEN THANH (PHARM D)
Entity type:Individual
Prefix:MISS
First Name:THAO
Middle Name:THIEN THANH
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 1:5661 BULLARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-3447
Mailing Address - Country:US
Mailing Address - Phone:504-243-3282
Mailing Address - Fax:504-245-4702
Practice Address - Street 1:5661 BULLARD AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-3447
Practice Address - Country:US
Practice Address - Phone:504-243-3282
Practice Address - Fax:504-245-4702
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist