Healthcare Provider Details

I. General information

NPI: 1346182573
Provider Name (Legal Business Name): HANAN ABU GHANNAM PCA/FIRSTAID/CPR/AED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6820 COMMERCIAL DR
SPRINGFIELD VA
22151
US

IV. Provider business mailing address

6820 COMMERCIAL DRIVE
SPRINGFIELD VA
22151
US

V. Phone/Fax

Practice location:
  • Phone: 571-683-6850
  • Fax: 571-833-1056
Mailing address:
  • Phone: 571-683-6850
  • Fax: 571-833-1056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-0006286
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: