Provider Demographics
NPI:1770062507
Name:TAIMURI, NASIBA (RN)
Entity type:Individual
Prefix:
First Name:NASIBA
Middle Name:
Last Name:TAIMURI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4063 N BELT LINE RD APT 2060
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-8538
Mailing Address - Country:US
Mailing Address - Phone:682-583-5277
Mailing Address - Fax:
Practice Address - Street 1:4063 N BELT LINE RD APT 2060
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-8538
Practice Address - Country:US
Practice Address - Phone:682-583-5277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX950398163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse