Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | RN236467 | GA |
NPI | 1295238723 |
---|---|
Provider Name | Thuy Thu-Thi Nguyen |
First Address | Augusta, GA 30901-2603 |
Second Address | Augusta, GA 30912-1067 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2018 |
Last Update Date | 03/05/2018 |