Provider Demographics
NPI:1265226914
Name:CLARK-HENTZ, ZARIFA
Entity type:Individual
Prefix:
First Name:ZARIFA
Middle Name:
Last Name:CLARK-HENTZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-2415
Mailing Address - Country:US
Mailing Address - Phone:623-401-6331
Mailing Address - Fax:
Practice Address - Street 1:401 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-2415
Practice Address - Country:US
Practice Address - Phone:623-401-6331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN171475163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse