Provider Demographics
NPI:1275301574
Name:PHAM, NATALIE QUYNH (PHARMD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:QUYNH
Last Name:PHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 N HILLS BLVD UNIT 60541
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-8045
Mailing Address - Country:US
Mailing Address - Phone:714-756-1782
Mailing Address - Fax:
Practice Address - Street 1:2389 WINGFIELD HILLS RD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-7201
Practice Address - Country:US
Practice Address - Phone:775-626-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20934183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist