Provider Demographics
NPI:1023840766
Name:NGUYEN, HIEU KIM (PHARMD)
Entity type:Individual
Prefix:
First Name:HIEU
Middle Name:KIM
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18441 DOUGLAS PLZ APT 211
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-5787
Mailing Address - Country:US
Mailing Address - Phone:714-391-3258
Mailing Address - Fax:
Practice Address - Street 1:505 S 45TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-2002
Practice Address - Country:US
Practice Address - Phone:402-559-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist