Healthcare Provider Details

I. General information

NPI: 1366351983
Provider Name (Legal Business Name): MY-DUYEN QUYNH NGUYEN RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8081 INNOVATION PARK DR
FAIRFAX VA
22031-4867
US

IV. Provider business mailing address

7023 LEEWOOD FOREST DR
SPRINGFIELD VA
22151-3923
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-0606
  • Fax:
Mailing address:
  • Phone: 703-606-8212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number0001309257
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: