Individual
KHADIJA MACAULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12018 SUNRISE VALLEY DR STE 100, RESTON, VA 20191-3444
(571) 262-2261
Mailing address
202 MARIANNE PL, STAFFORD, VA 22554-1621
(571) 275-0132
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001220128
VA
363LF0000X
Family Nurse Practitioner
Primary
0024186062
VA
Other
Enumeration date
01/12/2023
Last updated
08/20/2025
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