Healthcare Provider Details

I. General information

NPI: 1164019824
Provider Name (Legal Business Name): TRAMI T NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6637 ARLINGTON BLVD
FALLS CHURCH VA
22042-3002
US

IV. Provider business mailing address

8535 FOREST ST
ANNANDALE VA
22003-3623
US

V. Phone/Fax

Practice location:
  • Phone: 703-538-6926
  • Fax:
Mailing address:
  • Phone: 703-731-6555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number0202208496
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: