Provider Demographics
NPI:1396362851
Name:JABBAR, RAHIMAH (RN)
Entity Type:Individual
Prefix:
First Name:RAHIMAH
Middle Name:
Last Name:JABBAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 CHARTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SANDSTON
Mailing Address - State:VA
Mailing Address - Zip Code:23150-4120
Mailing Address - Country:US
Mailing Address - Phone:804-356-7353
Mailing Address - Fax:
Practice Address - Street 1:2012 CHARTWOOD LN
Practice Address - Street 2:
Practice Address - City:SANDSTON
Practice Address - State:VA
Practice Address - Zip Code:23150-4120
Practice Address - Country:US
Practice Address - Phone:804-356-7353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2023-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0939785447Medicaid