Healthcare Provider Details

I. General information

NPI: 1801523170
Provider Name (Legal Business Name): LYNDA PHUONG NGUYEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4615 UNIVERSITY DR
DURHAM NC
27707-3458
US

IV. Provider business mailing address

4615 UNIVERSITY DR
DURHAM NC
27707-3458
US

V. Phone/Fax

Practice location:
  • Phone: 919-287-6366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number31577
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: