Provider Demographics
NPI:1932809225
Name:NANZIRI, SANDRAH (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:SANDRAH
Middle Name:
Last Name:NANZIRI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:SANDRAH
Other - Middle Name:KAASA
Other - Last Name:NANZIRI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:2629 N 73RD DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85035-3253
Mailing Address - Country:US
Mailing Address - Phone:857-407-9104
Mailing Address - Fax:
Practice Address - Street 1:2629 N 73RD DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035-3253
Practice Address - Country:US
Practice Address - Phone:857-407-9104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2318904163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult