Provider Demographics
NPI:1255883542
Name:PHAN, THUYVAN THI (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:THUYVAN
Middle Name:THI
Last Name:PHAN
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 1:419 ALAMOSA PL
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-7322
Mailing Address - Country:US
Mailing Address - Phone:336-686-0508
Mailing Address - Fax:
Practice Address - Street 1:6013 FARRINGTON RD STE 200
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8194
Practice Address - Country:US
Practice Address - Phone:919-962-4824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC218541835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care