Healthcare Provider Details

I. General information

NPI: 1932019973
Provider Name (Legal Business Name): MELISSA NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 HENNESSY BLVD
BATON ROUGE LA
70808-4375
US

IV. Provider business mailing address

117 ELLINGTON DR
THIBODAUX LA
70301-8046
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-6565
  • Fax:
Mailing address:
  • Phone: 985-228-2825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.026315
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: