Healthcare Provider Details

I. General information

NPI: 1295252518
Provider Name (Legal Business Name): HENNA ZEHRA HABIB PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 GARRISONVILLE RD STE 201
STAFFORD VA
22554-1552
US

IV. Provider business mailing address

235 GARRISONVILLE RD STE 201
STAFFORD VA
22554-1552
US

V. Phone/Fax

Practice location:
  • Phone: 540-254-7899
  • Fax:
Mailing address:
  • Phone: 540-254-7899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110005910
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-13823
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0110005910
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: