Provider Demographics
NPI:1811383805
Name:JIWA, ZARINA (RN)
Entity Type:Individual
Prefix:
First Name:ZARINA
Middle Name:
Last Name:JIWA
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 1:109 SPRINGRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-8031
Mailing Address - Country:US
Mailing Address - Phone:817-929-4258
Mailing Address - Fax:972-812-1289
Practice Address - Street 1:109 SPRINGRIDGE LN
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76039-8031
Practice Address - Country:US
Practice Address - Phone:817-929-4258
Practice Address - Fax:972-812-1289
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX695832171M00000X, 174H00000X
695832372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator
No372600000XNursing Service Related ProvidersAdult Companion