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General NPI Number Information
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NPI Number | 1093560294
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Entity Type | Individual
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Provider Name | NOURA MOHAMED IBRAHIM ELEBIARY
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Gender | Female
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 1005 SUTTON WAY
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City | GRASS VALLEY
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State | CA
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Zip | 95945-5182
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Country | US
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Telephone | 530-272-8881
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Fax |
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Provider Business Mailing Address
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Address Line | 14845 DURDEN CT
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City | GRASS VALLEY
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State | CA
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Zip | 95949-9266
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Country | US
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Telephone | 530-887-1316
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH89377
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License Number State | CA
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