Healthcare Provider Details

I. General information

NPI: 1932326568
Provider Name (Legal Business Name): JASMINE S NABI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 10TH ST SE HPCC 3RD FLOOR
CEDAR RAPIDS IA
52403-1251
US

IV. Provider business mailing address

701 10TH ST SE HPCC 3RD FLOOR
CEDAR RAPIDS IA
52403-1251
US

V. Phone/Fax

Practice location:
  • Phone: 319-363-8303
  • Fax: 319-364-4659
Mailing address:
  • Phone: 319-363-8303
  • Fax: 319-364-4659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number37125
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number37125
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0700244
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer
# 2
IdentifierP00600416
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerRAILROAD MEDICARE
# 3
Identifier58952
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerWELLMARK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: