Individual
MRS. HOLLY T NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
64 CONCORD ST, STE C, WILMINGTON, MA 01887
(978) 988-9700
(978) 988-9701
Mailing address
64 CONCORD ST, STE C, WILMINGTON, MA 01887
(978) 988-9700
(978) 988-9701
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1035
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043480187
TAX ID
—
01
—
1035
LICENSE
MA
01
—
MN0377881J
CONTROL LIC
MA
Enumeration date
07/31/2006
Last updated
03/07/2023
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