Healthcare Provider Details

I. General information

NPI: 1891630679
Provider Name (Legal Business Name): SHAZIA ZIARAT ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

804 KINGSTON HILLS CT
FENTON MO
63026-4813
US

IV. Provider business mailing address

804 KINGSTON HILLS CT # 804
FENTON MO
63026-4813
US

V. Phone/Fax

Practice location:
  • Phone: 314-937-9140
  • Fax:
Mailing address:
  • Phone: 314-937-9140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2026014238
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: