Provider Demographics
NPI:1356727234
Name:NGUYEN, QUYNH-TRAM PHAM (RN)
Entity type:Individual
Prefix:
First Name:QUYNH-TRAM
Middle Name:PHAM
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 SILVER MAPLE PL
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3545
Mailing Address - Country:US
Mailing Address - Phone:408-334-1499
Mailing Address - Fax:
Practice Address - Street 1:3407 SILVER MAPLE PL
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3545
Practice Address - Country:US
Practice Address - Phone:408-334-1499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001243800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse