Healthcare Provider Details

I. General information

NPI: 1679418529
Provider Name (Legal Business Name): ZAINAB JIHAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 S 12TH ST
FORT SMITH AR
72901-4702
US

IV. Provider business mailing address

612 S 12TH ST
FORT SMITH AR
72901-4702
US

V. Phone/Fax

Practice location:
  • Phone: 479-424-3193
  • Fax: 479-242-0598
Mailing address:
  • Phone: 479-424-3193
  • Fax: 479-242-0598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: