Provider Demographics
NPI:1689203291
Name:SWEENEY, JILLIAN ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:ELIZABETH
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JILLIAN
Other - Middle Name:
Other - Last Name:FARRELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9200 CENTREVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-5131
Mailing Address - Country:US
Mailing Address - Phone:703-368-9146
Mailing Address - Fax:
Practice Address - Street 1:9200 CENTREVILLE RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5131
Practice Address - Country:US
Practice Address - Phone:703-368-9146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202213275183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist