Provider Demographics
NPI:1144881053
Name:OMAR, ZEYNAB A (RN, BSN)
Entity type:Individual
Prefix:
First Name:ZEYNAB
Middle Name:A
Last Name:OMAR
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MCANDREWS RD W APT 119
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-5745
Mailing Address - Country:US
Mailing Address - Phone:507-508-8182
Mailing Address - Fax:
Practice Address - Street 1:51 MCANDREWS RD W APT 119
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-5745
Practice Address - Country:US
Practice Address - Phone:507-508-8182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-23
Last Update Date:2019-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2471455163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse