Provider Demographics
NPI:1720807936
Name:NGUYEN, LAN ANH HOANG
Entity type:Individual
Prefix:
First Name:LAN ANH
Middle Name:HOANG
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 W BELL AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-3162
Mailing Address - Country:US
Mailing Address - Phone:641-828-6183
Mailing Address - Fax:
Practice Address - Street 1:814 W BELL AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-3162
Practice Address - Country:US
Practice Address - Phone:641-828-6183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA25161183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist