Healthcare Provider Details

I. General information

NPI: 1124939038
Provider Name (Legal Business Name): QUYNHTRAM NGUYEN PHARMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE NGUYEN PHARMD, MS

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 JEFFERSON HWY STE A
JEFFERSON LA
70121-2448
US

IV. Provider business mailing address

701 THIRBA ST
METAIRIE LA
70003-6333
US

V. Phone/Fax

Practice location:
  • Phone: 504-931-8177
  • Fax:
Mailing address:
  • Phone: 504-931-8177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.026357
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: