Provider Demographics
NPI:1255739348
Name:NGUYEN, HIEN-MINH
Entity type:Individual
Prefix:
First Name:HIEN-MINH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 STONE FALLS DR SE
Mailing Address - Street 2:APT 202
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-7928
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2799 10 MILE RD NE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-9100
Practice Address - Country:US
Practice Address - Phone:616-863-3433
Practice Address - Fax:616-863-3465
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020390261835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy