Provider Demographics
NPI:1255882189
Name:JAWARA, ISATOU JOOF (RN, MSHA)
Entity type:Individual
Prefix:
First Name:ISATOU
Middle Name:JOOF
Last Name:JAWARA
Suffix:
Gender:F
Credentials:RN, MSHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7724 BLACK WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4628
Mailing Address - Country:US
Mailing Address - Phone:682-203-4126
Mailing Address - Fax:
Practice Address - Street 1:7460 WARREN PKWY STE 166
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4169
Practice Address - Country:US
Practice Address - Phone:682-888-8471
Practice Address - Fax:682-203-4126
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-15
Last Update Date:2024-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX860550163WC0400X
TX1164306363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0400XNursing Service ProvidersRegistered NurseCase Management