Provider Demographics
NPI:1588642797
Name:ZIGLARI, MALIHEH (APRN)
Entity Type:Individual
Prefix:
First Name:MALIHEH
Middle Name:
Last Name:ZIGLARI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 946
Mailing Address - Street 2:
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-0946
Mailing Address - Country:US
Mailing Address - Phone:620-431-2500
Mailing Address - Fax:620-431-0914
Practice Address - Street 1:505 S PLUMMER AVE
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-1950
Practice Address - Country:US
Practice Address - Phone:620-431-2500
Practice Address - Fax:620-431-0914
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74064363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
500000475OtherRAINROAD MEDICARE
KS100247140AMedicaid
KS664790OtherFIRSTGUARD
KS100247140AMedicaid
KS010587Medicare ID - Type Unspecified