Provider Demographics
NPI:1679936041
Name:NAKBEEN, LINA
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:
Last Name:NAKBEEN
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 1:833 BLUEFIELD SQ NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6677
Mailing Address - Country:US
Mailing Address - Phone:571-278-2848
Mailing Address - Fax:
Practice Address - Street 1:4251 JOHN MARR DR
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3205
Practice Address - Country:US
Practice Address - Phone:703-354-6960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist