Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MED-RES-LIC--88122 | MT |
Y | 111NI0900X | Internist | MED-RES-LIC--88122 | MT |
NPI | 1003442013 |
---|---|
Provider Name | Jaclyn Nguyen |
First Address | Billings, MT 59107-5100 |
Second Address | Billings, MT 59101-0905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2020 |
Last Update Date | 12/07/2021 |