Provider Demographics
NPI:1215365234
Name:JAZRAWI, RANA
Entity Type:Individual
Prefix:
First Name:RANA
Middle Name:
Last Name:JAZRAWI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2834 ROSSMOOR CIR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1052
Mailing Address - Country:US
Mailing Address - Phone:248-470-2434
Mailing Address - Fax:
Practice Address - Street 1:2834 ROSSMOOR CIR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-1052
Practice Address - Country:US
Practice Address - Phone:248-470-2434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist