Individual
MARIANA THUYEN NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
770 WALNUT ST, MACON, GA 31201-7307
(478) 787-4266
(478) 787-4199
Mailing address
PO BOX 4363, MACON, GA 31208-4363
(478) 787-4266
(478) 787-4199
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN188608
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003146216A
—
GA
Enumeration date
09/17/2012
Last updated
05/28/2015
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