MEDICARE: FARZANA KOUSAR AGPNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	0024173456	VA
2	363L00000X	Nurse Practitioner	0024173456	VA

General Provider Information

NPI Number	:	1386008530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARZANA KOUSAR AGPNP

Provider Business Mailing Address
First Line	:	3535 S BALL ST STE A
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-4452
Country	:	US
Telephone Number	:	703-558-4922
Fax Number	:	703-228-9021

Provider Business Practice Location Address
First Line	:	3535 S BALL ST STE A
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22202-4452
Country	:	US
Telephone Number	:	703-558-4922
Fax Number	:	703-228-9021

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2016
Last Update Date	:	04/26/2024

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