Healthcare Provider Details

I. General information

NPI: 1659853851
Provider Name (Legal Business Name): SAMINA ZAFAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2018
Last Update Date: 11/10/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12212 SWANHAVEN DR
OKLAHOMA CITY OK
73170-4748
US

IV. Provider business mailing address

12212 SWANHAVEN DR
OKLAHOMA CITY OK
73170-4748
US

V. Phone/Fax

Practice location:
  • Phone: 405-821-7422
  • Fax:
Mailing address:
  • Phone: 405-821-7422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number88181
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number88181
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: