Provider Demographics
NPI:1386008530
Name:KOUSAR, FARZANA (AGPNP)
Entity Type:Individual
Prefix:
First Name:FARZANA
Middle Name:
Last Name:KOUSAR
Suffix:
Gender:F
Credentials:AGPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 S BALL ST STE A
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-4452
Mailing Address - Country:US
Mailing Address - Phone:703-558-4922
Mailing Address - Fax:703-228-9021
Practice Address - Street 1:3535 S BALL ST STE A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-4452
Practice Address - Country:US
Practice Address - Phone:703-558-4922
Practice Address - Fax:703-228-9021
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024173456363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner