Healthcare Provider Details

I. General information

NPI: 1972339315
Provider Name (Legal Business Name): ZEHRA SADIQUE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9535 W AGORA LN
TOLLESON AZ
85353-4565
US

IV. Provider business mailing address

9534 W AGORA LN
TOLLESON AZ
85353-4564
US

V. Phone/Fax

Practice location:
  • Phone: 602-515-9548
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRNP232625
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: