MEDICARE: DR. CAROLYN NGUYEN

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
1	183500000X	Pharmacist	0202216175	VA

General Provider Information

NPI Number	:	1386247211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLYN NGUYEN

Provider Business Mailing Address
First Line	:	8024 LITTLE RIVER TPKE
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-2324
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	735 N SAINT ASAPH ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-1911
Country	:	US
Telephone Number	:	703-419-3837
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2020
Last Update Date	:	07/15/2022

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