1659529485 NPI number — ZAHRA NEKOUIE HARRISON ANP

Table of content: ZAHRA NEKOUIE HARRISON ANP (NPI 1659529485)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659529485 NPI number — ZAHRA NEKOUIE HARRISON ANP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARRISON
Provider First Name:
ZAHRA
Provider Middle Name:
NEKOUIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ANP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659529485
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2920 N CASCADE AVE
Provider Second Line Business Mailing Address:
3RD FLOOR
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80907-6262
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-636-1201
Provider Business Mailing Address Fax Number:
719-636-1326

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2920 N CASCADE AVE
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80907-6262
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-636-1201
Provider Business Practice Location Address Fax Number:
719-636-1326
Provider Enumeration Date:
09/04/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  5745-NP , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)