Provider Demographics
NPI:1154721439
Name:NGUYEN, THU MINH (PHARMD)
Entity type:Individual
Prefix:MISS
First Name:THU
Middle Name:MINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4032 JESSICA LEIGH LN APT 205
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-2639
Mailing Address - Country:US
Mailing Address - Phone:419-324-6640
Mailing Address - Fax:
Practice Address - Street 1:3716 W W T HARRIS BLVD STE J
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-8517
Practice Address - Country:US
Practice Address - Phone:704-598-8773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-24
Last Update Date:2014-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24572183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist