Provider Demographics
NPI:1942077748
Name:MOHAMED, NADIA JAMAL (FNP)
Entity Type:Individual
Prefix:MISS
First Name:NADIA
Middle Name:JAMAL
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 DEL SOL DR APT 414
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3013
Mailing Address - Country:US
Mailing Address - Phone:619-317-5334
Mailing Address - Fax:
Practice Address - Street 1:610 DEL SOL DR APT 414
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3013
Practice Address - Country:US
Practice Address - Phone:619-317-5334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily