Provider Demographics
NPI:1639641699
Name:NUR, ZAHRA JEYLANI (NP)
Entity Type:Individual
Prefix:
First Name:ZAHRA
Middle Name:JEYLANI
Last Name:NUR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 W HOSPITALITY LN STE 1A
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3328
Mailing Address - Country:US
Mailing Address - Phone:909-723-1007
Mailing Address - Fax:
Practice Address - Street 1:15101 SPECTRUM
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3426
Practice Address - Country:US
Practice Address - Phone:619-319-0176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010495363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology