Provider Demographics
NPI:1316372576
Name:NUR, AFARH
Entity Type:Individual
Prefix:
First Name:AFARH
Middle Name:
Last Name:NUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15523 TRAVAILER CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-1013
Mailing Address - Country:US
Mailing Address - Phone:703-878-1384
Mailing Address - Fax:
Practice Address - Street 1:15523 TRAVAILER CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-1013
Practice Address - Country:US
Practice Address - Phone:703-878-1384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA13L25342172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker