Provider Demographics
NPI:1710680137
Name:TRAN, JAYCE H
Entity Type:Individual
Prefix:
First Name:JAYCE
Middle Name:H
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10818 WARWICK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-3741
Mailing Address - Country:US
Mailing Address - Phone:757-596-7646
Mailing Address - Fax:757-596-9469
Practice Address - Street 1:10818 WARWICK BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-3741
Practice Address - Country:US
Practice Address - Phone:757-596-7646
Practice Address - Fax:757-596-9469
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0230037498183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician