Provider Demographics
NPI:1578939922
Name:KHAN, YASMEEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:YASMEEN
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12025 TOWN SQUARE ST UNIT 1214
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-6036
Mailing Address - Country:US
Mailing Address - Phone:816-694-6784
Mailing Address - Fax:
Practice Address - Street 1:12025 TOWN SQUARE ST UNIT 1214
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-6036
Practice Address - Country:US
Practice Address - Phone:816-694-6784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211663183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist