Provider Demographics
NPI:1730742123
Name:KHAIRAN, HUDA ESSA (PHARMACIST)
Entity type:Individual
Prefix:
First Name:HUDA
Middle Name:ESSA
Last Name:KHAIRAN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 VANDERCASTEL RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5622
Mailing Address - Country:US
Mailing Address - Phone:202-817-8368
Mailing Address - Fax:
Practice Address - Street 1:609 E MAIN ST STE Q
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3182
Practice Address - Country:US
Practice Address - Phone:540-229-5144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-21
Last Update Date:2019-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202217504183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist