Provider Demographics
NPI:1538782990
Name:MUNIR, SHIREEN (RD)
Entity type:Individual
Prefix:
First Name:SHIREEN
Middle Name:
Last Name:MUNIR
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10137 EMPIRE CT
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5972
Mailing Address - Country:US
Mailing Address - Phone:609-933-2145
Mailing Address - Fax:
Practice Address - Street 1:3613 214TH ST SW
Practice Address - Street 2:
Practice Address - City:BRIER
Practice Address - State:WA
Practice Address - Zip Code:98036-6897
Practice Address - Country:US
Practice Address - Phone:609-933-2145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDI1528133V00000X
KY263723133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered