Provider Demographics
NPI:1023504263
Name:NGUYEN, DIANA LAVINDER (MD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:LAVINDER
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1020
Mailing Address - Country:US
Mailing Address - Phone:336-832-7272
Mailing Address - Fax:336-832-8641
Practice Address - Street 1:1200 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1020
Practice Address - Country:US
Practice Address - Phone:336-832-7272
Practice Address - Fax:336-832-8641
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC27002255A2300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer