Provider Demographics
NPI:1376057752
Name:ZAMAN, SHABNUM SHAKEEL (AG-ACNP)
Entity Type:Individual
Prefix:
First Name:SHABNUM
Middle Name:SHAKEEL
Last Name:ZAMAN
Suffix:
Gender:F
Credentials:AG-ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 STONE WATER DR APT 1015
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76120-2798
Mailing Address - Country:US
Mailing Address - Phone:817-235-1584
Mailing Address - Fax:
Practice Address - Street 1:816 STONE WATER DR APT 1015
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76120-2798
Practice Address - Country:US
Practice Address - Phone:817-235-1584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135839363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care