Provider Demographics
NPI:1902613953
Name:VANG, NHIA TONG
Entity type:Individual
Prefix:
First Name:NHIA
Middle Name:TONG
Last Name:VANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12841 ABLE ST NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-3263
Mailing Address - Country:US
Mailing Address - Phone:507-351-7582
Mailing Address - Fax:
Practice Address - Street 1:12841 ABLE ST NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-3263
Practice Address - Country:US
Practice Address - Phone:507-351-7582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide