Provider Demographics
NPI:1619569944
Name:HUSSIEN, OMNIA
Entity Type:Individual
Prefix:
First Name:OMNIA
Middle Name:
Last Name:HUSSIEN
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 1:500 DURANT ST APT 303
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7357
Mailing Address - Country:US
Mailing Address - Phone:352-226-3602
Mailing Address - Fax:
Practice Address - Street 1:4191 THE CIRCLE AT NORTH HILLS ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5712
Practice Address - Country:US
Practice Address - Phone:919-786-2534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61647183500000X
NC30128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist