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General NPI Number Information
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NPI Number | 1073956066
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Entity Type | Individual
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Provider Name | JIN-KYUNG HAN
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Gender | Female
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Dates
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Enumeration Date | 04/09/2013
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 5999 BURKE COMMONS RD
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City | BURKE
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State | VA
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Zip | 22015-2880
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Country | US
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Telephone | 703-249-7750
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Fax | 703-249-7776
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Provider Business Mailing Address
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Address Line | 5999 BURKE COMMONS RD
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City | BURKE
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State | VA
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Zip | 22015-2880
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Country | US
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Telephone | 703-249-7750
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Fax | 703-249-7776
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202012121
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License Number State | VA
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