Provider Demographics
NPI:1891326336
Name:ZAKIROV, RUSLAN R (FNP)
Entity Type:Individual
Prefix:
First Name:RUSLAN
Middle Name:R
Last Name:ZAKIROV
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 JOANNA DR
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-3042
Mailing Address - Country:US
Mailing Address - Phone:774-266-4020
Mailing Address - Fax:
Practice Address - Street 1:46 JOANNA DR
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-3042
Practice Address - Country:US
Practice Address - Phone:774-266-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2301955363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily