Individual provider · NPI-1

Diem Nguyen Chang, NP

Nurse Practitioner, Pediatrics · Thornton, CO

NPI number1073116125
StatusActive
Last updated in NPPESNov 20, 2020

Details

NPI
1073116125
Entity type
Individual (NPI-1)
Name
Diem Nguyen Chang
Credential
NP
Sex
Female
Sole proprietor
No
Enumeration date
Nov 20, 2020
Certification date
Nov 20, 2020
Last updated
Nov 20, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, PediatricsAPN.0995908COYes
163W00000X Registered NurseRN.1667433CO

Practice location

9195 Grant St
Thornton, CO 80229-4385

Phone 720-647-5858

Mailing address

1777 Wewatta St Apt 20619
Denver, CO 80202-6381

Phone 704-806-2625

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