Provider Demographics
NPI:1871184150
Name:NGUYEN, MAGGIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:BOI-NGOC
Other - Middle Name:XUAN
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24767 PRAIRIE GRASS DR
Mailing Address - Street 2:
Mailing Address - City:STONE RIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-2942
Mailing Address - Country:US
Mailing Address - Phone:571-226-7782
Mailing Address - Fax:
Practice Address - Street 1:8330 OLD KEENE MILL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1640
Practice Address - Country:US
Practice Address - Phone:703-569-1220
Practice Address - Fax:703-569-1220
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist