Individual
ZINA SHADFAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
HIGHWAY 264 MILEPOST 388, POLACCA, AZ 86042
(928) 737-6000
Mailing address
HIGHWAY 264 MILEPOST 388, POLACCA, AZ 86042
(928) 737-6000
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
870062
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020529
—
AZ
Enumeration date
09/23/2022
Last updated
09/23/2022
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