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NPI Code Detail

MEDICARE: QUYNH-TRAM PHAM NGUYEN RN

MEDICARE: QUYNH-TRAM PHAM NGUYEN RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse0001243800VA

General Provider Information

NPI Number : 1356727234
Entity Type Code : Individual
Provider Name (Legal Business Name) : QUYNH-TRAM PHAM NGUYEN RN
Provider Business Mailing Address
First Line : 3407 SILVER MAPLE PL
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22042-3545
Country : US
Telephone Number : 408-334-1499
Fax Number :
Provider Business Practice Location Address
First Line : 3407 SILVER MAPLE PL
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22042-3545
Country : US
Telephone Number : 408-334-1499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2015
Last Update Date : 08/03/2015

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