Provider Demographics
NPI:1477352789
Name:JARA, AZIZA A
Entity type:Individual
Prefix:
First Name:AZIZA
Middle Name:A
Last Name:JARA
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 1:9625 FLINTWOOD ST NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-5635
Mailing Address - Country:US
Mailing Address - Phone:763-269-9206
Mailing Address - Fax:
Practice Address - Street 1:9625 FLINTWOOD ST NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-5635
Practice Address - Country:US
Practice Address - Phone:763-269-9206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)