Provider Demographics
NPI:1366887655
Name:NGUYEN, TRANG T (PHARMD)
Entity type:Individual
Prefix:
First Name:TRANG
Middle Name:T
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 1:480 US HIGHWAY 287
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8919
Mailing Address - Country:US
Mailing Address - Phone:303-604-3070
Mailing Address - Fax:
Practice Address - Street 1:480 US HIGHWAY 287
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8919
Practice Address - Country:US
Practice Address - Phone:303-604-3070
Practice Address - Fax:303-604-3071
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17709183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist