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1265146229
KHADIJA MACAULLY
RESTON, VA
NPI
1265146229
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: VA 0024186062)
Enumeration Date
2023-01-12
Last Update Date
2023-01-12
Business Address
KHADIJA MACAULLY
12018 SUNRISE VALLEY DR STE 100
RESTON, VA 20191-3444
Phone number: 571-262-2261
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Mailing Address
KHADIJA MACAULLY
202 MARIANNE PL
STAFFORD, VA 22554-1621
Phone number: 571-275-0132
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