Provider Demographics
NPI:1588361810
Name:NGUYEN, NHAN THANH (NMD)
Entity type:Individual
Prefix:DR
First Name:NHAN
Middle Name:THANH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:901 S COUNTRY CLUB DR APT 2121
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3556
Mailing Address - Country:US
Mailing Address - Phone:320-237-3961
Mailing Address - Fax:
Practice Address - Street 1:1646 N LITCHFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-1253
Practice Address - Country:US
Practice Address - Phone:623-643-9598
Practice Address - Fax:623-478-0960
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22-1762175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath