Provider Demographics
NPI:1043102015
Name:NGUYEN, HIEU VAN (RN, SRNA)
Entity type:Individual
Prefix:
First Name:HIEU
Middle Name:VAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:RN, SRNA
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:VAN
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, SRNA
Mailing Address - Street 1:413 BLOOM ST APT 101A
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-1609
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-0001
Practice Address - Country:US
Practice Address - Phone:570-271-6211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN742980163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse