Individual provider Active NPI

Kim-Phuc Nguyen

  • Pharmacist
  • Kenner, LA
National Provider Identifier
1962830067
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
020365 Issued in LA
Practice address
1301 Williams Blvd
Kenner, LA 70062-6507
Phone
(504) 468-2361
NPI assigned
Oct 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 020365 LA Primary

Addresses

Primary practice location

1301 Williams Blvd
Kenner, LA 70062-6507

Mailing address

1913 Brighton PL
Harvey, LA 70058-1413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
020365LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
KTN Pharmacy LLC CurrentSince Apr 6, 2025 Accepting new patients
KTN Pharmacy LLC CurrentSince Apr 6, 2025 Accepting new patients

Locations

1301 Williams Blvd
Kenner, LA 70062
Phone (504) 468-2361

1623 Williams Blvd
Kenner, LA 70062
Phone (504) 468-2361

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1962830067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 BRIGHTON PL",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700581413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 WILLIAMS BLVD",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700626507",
            "telephone_number": "504-468-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM-PHUC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-29",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "020365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenner, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.