Islam, Kaniz Fatema

Islam, Kaniz Fatema is an individual health care provider with primary practice located at 5209 W Siesta Way , Laveen AZ 85339-7179. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Islam, Kaniz Fatema can be contacted via phone (602) 550-1008.

Contact Information

Primary practice address
5209 W Siesta Way Laveen AZ 85339-7179
Phone: (602) 550-1008
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X AZ5476 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN154095 Arizona

Profile Details

NPI number 1366860843
LBN Legal business name Islam, Kaniz Fatema
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2014
Last updated Sep 16th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366860843 NPPES
Arizona MEDICAID 902324

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