Provider Demographics
NPI:1831705136
Name:JAMA-GRUPP, RAHMA SHUKRI
Entity type:Individual
Prefix:MRS
First Name:RAHMA
Middle Name:SHUKRI
Last Name:JAMA-GRUPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 S OLD ORCHARD LN STE 12
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4374
Mailing Address - Country:US
Mailing Address - Phone:972-436-7962
Mailing Address - Fax:
Practice Address - Street 1:502 S OLD ORCHARD LN STE 12
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4374
Practice Address - Country:US
Practice Address - Phone:972-436-7962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60975428163WP0200X
WA61524087363LP0200X
TX1165348363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics