Healthcare Provider Details

I. General information

NPI: 1609202191
Provider Name (Legal Business Name): XUAN NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 08/15/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 HARDING PL SUITE 3100
CHARLOTTE NC
28204
US

IV. Provider business mailing address

7725 WHISTLESTOP RD
CHARLOTTE NC
28210-6920
US

V. Phone/Fax

Practice location:
  • Phone: 704-373-0212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number21311
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: