Provider Demographics
NPI:1194477687
Name:NGUYEN, NGOC-HIEU THI (PA-C)
Entity type:Individual
Prefix:
First Name:NGOC-HIEU
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 SHERRI MAR ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-7515
Mailing Address - Country:US
Mailing Address - Phone:480-516-3544
Mailing Address - Fax:
Practice Address - Street 1:2226 SHERRI MAR ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-7515
Practice Address - Country:US
Practice Address - Phone:480-516-3544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant