Provider Demographics
NPI:1760896757
Name:KHUSHNUD, TASNIMA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TASNIMA
Middle Name:
Last Name:KHUSHNUD
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 1:203 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2650
Mailing Address - Country:US
Mailing Address - Phone:540-371-8249
Mailing Address - Fax:540-361-1279
Practice Address - Street 1:203 KINGS HWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2650
Practice Address - Country:US
Practice Address - Phone:540-371-8249
Practice Address - Fax:540-361-1279
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212161183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist