Provider Demographics
NPI:1215821558
Name:HAIDOW, NADIA KHAM
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:KHAM
Last Name:HAIDOW
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:NADIA
Other - Middle Name:KHAM
Other - Last Name:HAIDOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13415 W RANGE MULE DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-5651
Mailing Address - Country:US
Mailing Address - Phone:480-433-8684
Mailing Address - Fax:
Practice Address - Street 1:13415 W RANGE MULE DR
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-5651
Practice Address - Country:US
Practice Address - Phone:480-433-8684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ$$$$$$$$$171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter